Robot/Endoscope–Assisted Selective Neck Dissection by a Postauricular Facelift Approach for cN0 SCCHN

Abstract

Objectives:

We have developed a new novel neck dissection procedure by postauricular facelift incision using the da Vinci robot or endoscope to avoid a long visible neck scar. The aim of this study is to investigate the feasibility and efficacy of this novel procedure in squamous cell carcinoma of head and neck (SCCHN) comparing with conventional neck dissection.

Methods:

We analyzed 30 SCCHN patients with clinically node negative neck (cN0) who underwent robot/endoscope assisted selective neck dissection (SND) by postauricular facelift approach (11 patients, 12 necks) or conventional neck dissection (19 patients, 21 necks).

Results:

The distributions of gender and age did not differ between the two groups. The extent of SND was level I, II, and III in oral cancer, and level II, III, with/without IV, V in oropharynx, larynx, and hypopharynx cancer in both group. The robot/endoscope assisted SND was completed successfully in all patients. The mean operative time of SND was longer in the robot/endoscope group (219 ± 65 min) than the conventional group (144 ± 43 min) (P < 0.05). The mean number of lymph nodes removed was 24.6 ± 8.0 and 28.9 ± 8.2 in the robot/endoscope and conventional group, respectively (P = 0.151), and the number of lymph nodes removed in each levels also did not differ between the two groups. There was no major postoperative complication in both groups.

Conclusions:

Robot or endoscope assisted SND by postauricular facelift approach is a cosmetically excellent procedure and comparable to conventional neck dissection in selected patients with cN0 SCCHN.