Free flap reconstruction after robot-assisted neck dissection via a modified face-lift or retroauricular approach.

Abstract:

BACKGROUND:We performed robot-assisted neck dissection (RAND) via a modified face-lift (MFLA) or retroauricular approach for neck management and carried out free flap reconstruction via these approaches in patients with head and neck cancer. We assessed the feasibility of free flap reconstruction in patients who had undergone transoral resection of a primary lesion and RAND via these approaches. METHODS:In this prospective study, seven patients with head and neck squamous cell carcinoma were enrolled between August 2011 and May 2012. Approval was obtained from the institutional review board of Yonsei University. A radial forearm free flap was used for reconstruction because of its thin structure and pliability. Microvascular anastomosis was performed via an MFLA or retroauricular approach using a microscope and microvascular instrument set. RESULTS:Pathology reports showed a negative margin in all patients. On the basis of pathologic information for the primary lesion and neck specimens, 5 patients underwent surgery alone and two received adjuvant radiotherapy. At the last outpatient department visit, all patients were alive without locoregional recurrence. All patients were extremely satisfied with the invisible postoperative scar. On average, patients tolerated an oral diet after 1-2 weeks. The status of the free flap was viable and functioning in all patients. CONCLUSIONS:Although long-term follow-up of oncologic safety is required to establish these approaches as valid treatment methods, our study has demonstrated the feasibility of free flap reconstruction and RAND via an MFLA or retroauricular approach.

journal_name

Ann Surg Oncol

authors

Park YM,Lee WJ,Yun IS,Lee DW,Lew DH,Lee JM,Ha JG,Kim WS,Koh YW,Choi EC

doi

10.1245/s10434-012-2731-6

subject

Has Abstract

pub_date

2013-03-01 00:00:00

pages

891-8

issue

3

eissn

1068-9265

issn

1534-4681

journal_volume

20

pub_type

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