Advertisement

Annals of Surgical Oncology

, Volume 20, Issue 3, pp 891–898 | Cite as

Free Flap Reconstruction After Robot-Assisted Neck Dissection Via a Modified Face-Lift or Retroauricular Approach

  • Young Min Park
  • Won Jai Lee
  • In Sik Yun
  • Dong Won Lee
  • Dae Hyun Lew
  • Jeon Mi Lee
  • Jong-Gyun Ha
  • Won Shik Kim
  • Yoon Woo KohEmail author
  • Eun Chang Choi
Head and Neck Oncology

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.

Keywords

Neck Dissection Free Flap Selective Neck Dissection Transoral Laser Microsurgery Oral Cavity Cancer 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgment

We thank the professional editors who helped prepare the English-language version of this document.

Disclosure

The authors have no funding, financial relationships, or conflict of interest to disclose.

Supplementary material

Supplementary material 1 (WMV 133755 kb)

Supplementary material 2 (WMV 12513 kb)

Supplementary material 3 (WMV 76052 kb)

References

  1. 1.
    Rodrigo JP, Shah JP, Silver CE, et al. Management of the clinically negative neck in early-stage head and neck cancers after transoral resection. Head Neck. 2011;33:1210–9.PubMedCrossRefGoogle Scholar
  2. 2.
    Park YM, Lee WJ, Lee JG, et al. Transoral robotic surgery (TORS) in laryngeal and hypopharyngeal cancer. J Laparoendosc Adv Surg Tech A. 2009;19:361–8.PubMedCrossRefGoogle Scholar
  3. 3.
    Park YM, Lee JG, Lee WS, Choi EC, Chung SM, Kim SH. Feasibility of transoral lateral oropharyngectomy using a robotic surgical system for tonsillar cancer. Oral Oncol. 2009;45:e62–6.PubMedCrossRefGoogle Scholar
  4. 4.
    Park YM, Kim WS, Byeon HK, De Virgilio A, Jung JS, Kim SH. Feasiblity of transoral robotic hypopharyngectomy for early-stage hypopharyngeal carcinoma. Oral Oncol. 2010;46:597–602.PubMedCrossRefGoogle Scholar
  5. 5.
    Koh YW, Chung WY, Hong HJ, et al. Robot-assisted selective neck dissection via modified face-lift approach for early oral tongue cancer: a video demonstration. Ann Surg Oncol. 2012;19:1334–5.PubMedCrossRefGoogle Scholar
  6. 6.
    Lee HS, Kim WS, Hong HJ, et al. Robot-assisted supraomohyoid neck dissection via a modified face-lift or retroauricular approach in early-stage cN0 squamous cell carcinoma of the oral cavity: a comparative study with conventional technique. Ann Surg Oncol. 2012;19:3871–8.Google Scholar
  7. 7.
    Terris DJ, Tuffo KM, Fee WE. Modified facelift incision for parotidectomy. J Laryngol Otol. 1994;108:574–8.PubMedCrossRefGoogle Scholar
  8. 8.
    Terris DJ, Singer MC, Seybt MW. Robotic facelift thyroidectomy: II. Clinical feasibility and safety. Laryngoscope. 2011;121:1636–41.PubMedCrossRefGoogle Scholar
  9. 9.
    Ghanem TA. Transoral robotic-assisted microvascular reconstruction of the oropharynx. Laryngoscope. 2011;121:580–2.PubMedCrossRefGoogle Scholar
  10. 10.
    Selber JC. Transoral robotic reconstruction of oropharyngeal defects: a case series. Plast Reconstr Surg. 2010;126:1978–87.PubMedCrossRefGoogle Scholar
  11. 11.
    Moore EJ, Olsen KD, Martin EJ. Concurrent neck dissection and transoral robotic surgery. Laryngoscope. 2011;121:541–4.PubMedCrossRefGoogle Scholar

Copyright information

© Society of Surgical Oncology 2012

Authors and Affiliations

  • Young Min Park
    • 1
  • Won Jai Lee
    • 2
  • In Sik Yun
    • 2
  • Dong Won Lee
    • 2
  • Dae Hyun Lew
    • 2
  • Jeon Mi Lee
    • 1
  • Jong-Gyun Ha
    • 1
  • Won Shik Kim
    • 1
  • Yoon Woo Koh
    • 1
    Email author
  • Eun Chang Choi
    • 1
  1. 1.Department of OtorhinolaryngologyYonsei University College of MedicineSeoulSouth Korea
  2. 2.Department of Plastic and Reconstructive SurgeryYonsei University College of MedicineSeoulSouth Korea

Personalised recommendations