Abstract
Background
This study evaluates the feasibility of endoscope-assisted second branchial cleft cyst resection via retroauricular approach by comparing it with conventional cervical incision for removal of second branchial cleft cyst.
Methods
From January 2009 to December 2010, 25 patients were randomly assigned to the endoscope-assisted surgery group (13 patients) or the conventional surgery group (12 patients). The clinical characteristics of patients, operation time, operative bleeding volume, postoperative complications, and subjective satisfaction with incision scar checked by visual analog scale were compared between the groups, retrospectively.
Results
All 13 second branchial cleft cyst resections were successfully performed endoscopically, and the wounds healed uneventfully. Endoscope-assisted surgery lasted 54.6 ± 6.3 min, and conventional surgery lasted 49.6 ± 6.9 min (P = 0.069). Degree of bleeding volume did not differ between the groups (P = 0.624). Mean patient satisfaction score was 9.2 ± 0.6 in the endoscope-assisted surgery group and 6.2 ± 0.8 in the controls (P < 0.001). All 13 patients in the endoscope-assisted surgery group were satisfied with their cosmetic results. One case showed temporary numbness around the earlobe that recovered within 1 month after surgery. No marginal nerve palsy occurred. No complications such as bleeding, salivary fistula, or paresis of the marginal mandibular branch occurred. All 25 patients were disease free with follow-up of 6–24 months (median 16 months).
Conclusions
Endoscope-assisted second branchial cleft cyst resection via retroauricular approach is a feasible technique. This procedure may serve as an alternative approach that allows an invisible incision and better cosmetic results.
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References
Acierno SP, Waldhausen JH (2007) Congenital cervical cysts, sinuses and fistulae. Otolaryngol Clin North Am 40:161–176
Agaton-Bonilla FC, Gay-Escoda C (1996) Diagnosis and treatment of branchial cleft cysts and fistulae. A retrospective study of 183 patients. Int J Oral Maxillofac Surg 25:449–452
Gagner M (1996) Endoscopic subtotal parathyroidectomy in patients with primary hyperparathyroidism. Br J Surg 83:875
Hüscher CS, Chiodini S, Napolitano C, Recher A (1997) Endoscopic right thyroid lobectomy. Surg Endosc 11:877
Miccoli P, Bendinelli C, Berti P, Vignali E, Pinchera A, Marcocci C (1999) Video-assisted versus conventional parathyroidectomy in primary hyperparathyroidism: a prospective randomized study. Surgery 126:1117–1121
Ohgami M, Ishii S, Arisawa Y, Ohmori T, Noga K, Furukawa T, Kitajima M (2000) Scarless endoscopic thyroidectomy: breast approach for better cosmesis. Surg Laparosc Endosc Percutan Tech 10:1–4
Huang XM, Zheng YQ, Liu X, Sun W, Zeng L, Cai X, Liu W, Xu Y, Zhang Z, Huang H (2009) A comparison between endoscope-assisted partial parotidectomy and conventional partial parotidectomy. Otolaryngol Head Neck Surg 140:70–75
Huang XM, Sun W, Liu X, Liu W, Guan Z, Xu Y, Zheng Y (2009) Endoscope-assisted partial-superficial parotidectomy through a concealed postauricular skin incision. Surg Endosc 23:1614–1619
Sun W, Xu YD, Zheng YQ, Liu X, Zeng L, Liu W, Huang X (2009) Endoscope-assisted partial-superficial parotidectomy through two small skin incisions. Acta Otolarygol 129:1493–1497
Huang XM, Sun W, Zeng L, Liu X, Lu X, Xu YD, Zhang ZG, Xu G (2011) Gasless endoscopic thyroidectomy via an anterior chest approach—a review of 219 cases with benign tumor. World J Surg 35:1281–1286
Chen WL, Fang SL (2009) Removal of second branchial cleft cysts using a retroauricular approach. Head Neck 31:695–698
Hughes J, Stephens J, Amonoo-Kuofi K, Mochloulis G (2009) Facelift approach to upper cervical surgery. Otolaryngol Head Neck Surg 141:783–785
Roh JL (2005) Retroauricular hairline incision for removal of upper neck masses. Laryngoscope 115:2161–2166
Roh JL, Yoon YH (2008) Removal of pediatric branchial cleft cyst using a retroauricular hairline incision (RAHI) approach. Int J Pediatr Otorhinolaryngol 72:1503–1507
Guerrissi JO (2010) Minimal invasive surgery in head and neck: video-assisted technique. J Craniofac Surg 21:882–886
Matsui Y, Iwai T, Tohnai I, Maegawa J (2008) Endoscopically assisted resection of a branchial cyst. Br J Oral Maxillofac Surg 46:336–337
Markkanen-Leppänen M, Pitkäranta A (2004) Parotidectomy using the Harmonic scalpel. Laryngoscope 114:381–382
Terris DJ, Seybt MW, Gourin CG, Chin E (2006) Ultrasonic technology facilitates minimal access thyroid surgery. Laryngoscope 116:851–854
Acknowledgements
The authors thank Karl-Storz Corporation and Johnson & Johnson Corporation for providing surgical equipment.
Disclosures
Authors Liang-si Chen, Wei Sun, Pei-na Wu, Si-yi Zhang, Mi-mi Xu, Xiao-ning Luo, Jian-dong Zhan, and Xiaoming Huang have no conflicts of interest or financial ties to disclose.
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Liang-si Chen and Wei Sun contributed equally to this work.
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Chen, Ls., Sun, W., Wu, Pn. et al. Endoscope-assisted versus conventional second branchial cleft cyst resection. Surg Endosc 26, 1397–1402 (2012). https://doi.org/10.1007/s00464-011-2046-x
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DOI: https://doi.org/10.1007/s00464-011-2046-x