Surgical approaches in neck dissection: Comparing functional, oncologic and aesthetic aspects of transverse cervicotomy to Paul André’s approach

Garcı́a-Dorado, David; Moris, Vivien; Hindi, A. Al; Rem, K.; Chatel, H.; See, L.-A.; Revol, M.; Dorval, S. Mazouz

doi:10.1016/j.anplas.2017.07.017

Cited by 10 publications

(14 citation statements)

References 16 publications

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“…A recent study published by Guillier et al compares the use of the Paul-André, or J incision, with the transverse incision, with the perception regarding the aesthetic result by the surgeon and patient satisfaction between both groups being the only statistically significant parameters, in both cases in favors of the transverse incision group. 21 In our study, we found significant results regarding aesthetic perception, but we could not find any difference…”

Section: Discussioncontrasting

confidence: 59%

Functional Results of Transverse Extended Incision in Cervical Neck Dissection

Chiesa‐Estomba

Sistiaga-Suárez

Thomas-Arrizabalaga

et al. 2020

Int Arch Otorhinolaryngol

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Introduction Multiple incisions have been described for the surgical approach of cervical neck nodes. All of these descriptions are associated with better or worse exposure of the surgical field as well as with different functional and aesthetic results, which are not always satisfactory. Objective Compare the transverse cervical incision with the classic incision in J or U. Methods This is a retrospective study of 47 patients who required cervical neck dissection between June 15, 2016 and June 15, 2017.A transversal incision was made in these surgeries, and their results were then compared with those of a group of 57 patients treated between January 1, 2010 and January 1, 2012, in whose cases an incision in J or U was made. Results Regarding the incision type, complications were present in 4 (8.5%) cases in the transversal incision group, and in 7 (12.2%) patients of the group of traditional incisions in J or U, without statistical differences (p = 0.078). The only variables associated with complications of healing in the two groups was body mass index (BMI) < 18.5. The patients showed subjective satisfaction with the aesthetic result of the transverse incision, with an average of 7.51 vs 6.20 in the J or U incision. Conclusion The transverse incision represents a safe, aesthetic, and oncologically adequate option, associated with a lower cicatricial retraction rate, without significant complication rate and allowing adequate exposure of the surgical field, similar to the obtained with the classic incision in J or U.

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Section: Discussioncontrasting

confidence: 59%

Functional Results of Transverse Extended Incision in Cervical Neck Dissection

Chiesa‐Estomba

Sistiaga-Suárez

Thomas-Arrizabalaga

et al. 2020

Int Arch Otorhinolaryngol

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“…On the other hand, double horizontal incisions of the Mc Fee type compromise flap irrigation, especially to the intermediate dermal bridge. The Paul André or "hockey stick" or "J incision", which is the most commonly used, has a vertical portion that opposes the Langer lines and facilitates the formation of keloid tissue or dermal contracture 8 .…”

Section: Discussionmentioning

confidence: 99%

Radical neck dissection: Oncological, aesthetic and functional approach in patients with head and neck cancer

Gallegos-Hernández¹,

Abrego-Vásquez²,

Zaleta-González³

2022

GAMO

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Background: The type of cervical incision is fundamental to achieve an adequate exposure to the lymphatic levels and to be able to perform a complete neck dissection and a proper staging of the patient; incomplete dissection sub-stages and increases the risk of recurrence. The incision must also offer the lowest morbidity, without aesthetic or functional sequelae; it must combine oncological safety with adequate aesthetics, functionality, and quality of life. Material and methods: A retrospective and observational study in which we evaluate the transverse cervical incision by knowing the number of dissected lymph nodes and complications rate associated to the incision. Results: Forty patients, 35 with squamous cell carcinoma metastasis and 5 with melanoma metastasis. The average of dissected lymph nodes was 25. A single incision allowed the dissection of the five ganglion levels; it was not necessary to convert the incision or make vertical enlargements; the cosmetic result was satisfactory in all patients, there were no significant complications. Conclusion: The transverse cervical incision allows access to the five cervical levels, in the present series the average of dissected lymph nodes was enough to consider the complete procedure. The aesthetic result was satisfactory, and there were no significant complications associated.

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“…Por otro lado, las incisiones horizontales dobles tipo Mc Fee comprometen la irrigación de los colgajos, sobre todo del puente dérmico intermedio, la incisión tipo Paul André o «en palo de hockey» o «en J», la más comúnmente usada, tiene una porción vertical que se opone a las líneas de Langer y facilita la formación de queloide o contractura dérmica 8 .…”

Section: Discussionunclassified

Disección radical de cuello: abordaje oncológico, estético y funcional en pacientes con cáncer de cabeza y cuello

Gallegos-Hernández¹,

Abrego-Vásquez²,

Zaleta-González³

2019

GAMO

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El tipo de incisión cervical es fundamental para lograr exposición adecuada a los niveles ganglionares y poder realizar una disección de cuello (DC) completa y que estadifique adecuadamente al paciente; la disección incompleta subestadifica e incrementa el riesgo de recaída. La incisión debe además ofrecer la menor morbilidad, sin secuelas estéticas ni funcionales, debe de combinar la seguridad oncológica con una adecuada estética, funcionalidad y calidad de vida. Material y métodos: Estudio retrospectivo y observacional en el que se evaluó la incisión cervical transversa al conocer el número de ganglios disecados y sus complicaciones. Resultados: Cuarenta pacientes, 35 con metástasis de carcinoma epidermoide y 5 con metástasis de melanoma. La media de ganglios disecados fue de 25. Una sola incisión permitió la disección de los cinco niveles ganglionares, no se requirió convertir la incisión ni hacer ampliaciones verticales; el resultado cosmético fue satisfactorio en todos los pacientes, no hubo complicaciones mayores. Conclusión: La incisión cervical transversa permite acceso a los cinco niveles cervicales. En la presente serie la media de ganglios disecados fue de 25, número suficiente para considerar al procedimiento completo. El resultado estético es satisfactorio y no se presentaron complicaciones mayores asociadas a ella.

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Surgical approaches in neck dissection: Comparing functional, oncologic and aesthetic aspects of transverse cervicotomy to Paul André’s approach

Cited by 10 publications

References 16 publications

Functional Results of Transverse Extended Incision in Cervical Neck Dissection

Functional Results of Transverse Extended Incision in Cervical Neck Dissection

Radical neck dissection: Oncological, aesthetic and functional approach in patients with head and neck cancer

Disección radical de cuello: abordaje oncológico, estético y funcional en pacientes con cáncer de cabeza y cuello

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