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A Study Comparing Free-Flap Reconstruction via the Retroauricular Approach and the Traditional Transcervical Approach for Head and Neck Cancer: A Matched Case-Control Study

 Won Shik Kim  ;  Jae Hong Park  ;  Hyung Kwon Byeon  ;  Jae Won Chang  ;  Myung Jin Ban  ;  Yoon Woo Koh  ;  Eun Chang Choi 
 Annals of Surgical Oncology, Vol.22(Suppl 3) : S349-S354, 2015 
Journal Title
 Annals of Surgical Oncology 
Issue Date
Adult ; Aged ; Case-Control Studies ; Female ; Follow-Up Studies ; Free Tissue Flaps* ; Head and Neck Neoplasms/pathology ; Head and Neck Neoplasms/surgery* ; Humans ; Male ; Middle Aged ; Neck Dissection/instrumentation ; Neck Dissection/methods* ; Neoplasm Staging ; Prognosis ; Reconstructive Surgical Procedures/methods* ; Surgical Flaps*
BACKGROUND: Free-flap reconstruction via a retroauricular approach (RRA) after robot-assisted neck dissection (RAND) could have cosmetic benefits. This study aimed to compare the surgical outcomes of free-flap reconstruction via a RRA and via a transcervical approach in head and neck cancer. METHODS: For this matched case-control study, 50 patients with head and neck cancer requiring free-flap reconstruction were divided into two groups: those reconstructed via a RRA group and those reconstructed via a transcervical approach (RTA group). The total operation time for free-flap reconstruction, the flap survival rate, the length of the hospital stay, the complications, and the scar satisfaction scores were compared between the two groups. RESULTS: The RRA group comprised 25 patients, and the RTA group had 25 patients. The mean operation time for reconstruction was 288 ± 77 min in the RRA group and 250 ± 98 min in the RTA group (p = 0.132). Flap failure occurred for two patients in the RRA group (8 %) and for one patient in the RTA group (4 %) (p = 1.000). The mean hospital stay was 21 ± 18 days in the RRA group and 23 ± 14 days in the RTA group (p = 0.669). The complications were comparable between the two groups. However, the overall scar satisfaction was significantly higher in the RRA group (p = 0.000). CONCLUSIONS: For patients with head and neck cancer, RRA has better cosmetic outcomes than RTA. The RRA approach could be used for select patients who undergo RAND and prefer to avoid a visible anterior neck scar.
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1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Otorhinolaryngology (이비인후과학교실)
Yonsei Authors
고윤우(Kho, Yoon Woo) ; 김원식(Kim, Won Shik) ; 변형권(Byeon, Hyung Kwon) ; 최은창(Choi, Eun Chang)
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