Subscribe to RSS
Functional Results of Transverse Extended Incision in Cervical Neck Dissection
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.
Received: 11 December 2018
Accepted: 30 October 2019
24 April 2020 (online)
© 2020. Fundação Otorrinolaringologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil
- 1 Crile GW. Excision of cáncer of the head and neck. With special reference to the plan of dissection base don 132 operations. JAMA 1906; 47: 1780-1786
- 2 Suarez O. El problema de las metástasis linfáticas y alejadas del cáncer de laringe e hipofaringe. Rev Bras Otorrinolaringol 1963; 23: 83-99
- 3 Gavilán J, Moñoux A, Herranz J, Gavilán C. Functional neck dissection: Surgical technique. Oper Tech Otolaryngol--Head Neck Surg 1993; 4: 258-265
- 4 Bocca E, Pignataro O, Sasaki CT. Functional neck dissection. A description of operative technique. Arch Otolaryngol 1980; 106 (09) 524-527
- 5 Robbins KT, Clayman G, Levine PA. et al; American Head and Neck Society, American Academy of Otolaryngology--Head and Neck Surgery. Neck dissection classification update: revisions proposed by the American Head and Neck Society and the American Academy of Otolaryngology-Head and Neck Surgery. Arch Otolaryngol Head Neck Surg 2002; 128 (07) 751-758
- 6 Kocher Th. Extirpatio linguae. Deutsche Zeitschrift für Chir. 1880; 13: 146
- 7 Küttner H. Ueber die lymphgefásse und lymphdrüsen der Zunge mit beziehung auf die verbreitung des zungencarcinoms. Beitrage für Klinischen Chir. 1898; 21: 732
- 8 Martin H, Del Valle B, Ehrlich H, Cahan WG. Neck dissection. Cancer 1951; 4 (03) 441-499
- 9 Macfee WF. Transverse incisions for neck dissection. Ann Surg 1960; 151: 279-284
- 10 Folz BJ, Silver CE, Rinaldo A, Ferlito A. Themistocles Gluck: biographic remarks emphasising his contributions to laryngectomy. Eur Arch Otorhinolaryngol 2011; 268 (08) 1175-1179
- 11 Attie JN. A single transverse incision for radical neck dissection. Surgery 1957; 41 (03) 498-502
- 12 Becker GD. The extended single transverse neck incision for composite resections. Surg Gynecol Obstet 1979; 148 (01) 90-92
- 13 Kambic V, Sirca A. [Vascularization of the skin of the neck and its significance for the cutting method in radical neck dissection]. HNO 1967; 15 (02) 46-49
- 14 Rabson JA, Hurwitz DJ, Futrell JW. The cutaneous blood supply of the neck: relevance to incision planning and surgical reconstruction. Br J Plast Surg 1985; 38 (02) 208-219
- 15 On the anatomy and physiology of the skin. IV. The swelling capabilities of skin by Professor K. Langer presented at the meeting of 27th November 1861. Br J Plast Surg 1978; 31 (04) 273-276
- 16 Chagas JF, Pascoal MB, Aquino JL. et al. Single transverse extended incision for radical neck dissection. Rev Col Bras Cir 2016; 43 (04) 270-275
- 17 Ellis M. Surgical techniques following irradiation of the neck. J Laryngol Otol 1963; 77: 872-908
- 18 Stell PM. Transverse incisions for radical neck dissection. Br J Surg 1969; 56 (04) 286-288
- 19 Babcock Jr WW, Conley J. Neck incision in block dissection. Experiences with the long anterior cervical flap incision. Arch Otolaryngol 1966; 84 (05) 554-557
- 20 Acar A, Dursun G, Aydin O, Akbaş Y. J incision in neck dissections. J Laryngol Otol 1998; 112 (01) 55-60
- 21 Guillier D, Moris V, Al Hindi AA. et al. Surgical approaches in neck dissection: Comparing functional, oncologic and aesthetic aspects of transverse cervicotomy to Paul André's approach. Ann Chir Plast Esthet 2017; ••• pii: S0294–1260(17)30122-X [Epub ahead of print] DOI: 10.1016/j.anplas.2017.07.017.
- 22 Robinson TJ, Thomas S, Dinan MA, Roman S, Sosa JA, Hyslop T. How Many Lymph Nodes Are Enough? Assessing the Adequacy of Lymph Node Yield for Papillary Thyroid Cancer. J Clin Oncol 2016; 34 (28) 3434-3439