후두 및 하인두암의 경부곽청술에 있어서 삼분기(Trifurcation)를 없앤 피부절개법

Abstract

The fact that so many types of incisions for neck dissection exist is strong testimony that there is hardly one incision that fits all contingencies. Factors that influence the choice are adequate exposure, changeability to other types of neck dissection, optimal exposure of the primary site and/or opposite side of the neck, and safety of the neck flap and cosmesis. Commonly used incisions have trifurcations for their adequate exposure, but trifurcation also have a tendency to expose carotid artery and scar contracture. The hockey stick incision, a single cuvilinear incision over the natural skin crease affords adequate exposure from level Ⅱ to Ⅴ. Level Ⅰ can also be cleared with contralateral incision for the laryngeal and hypopharyngeal primaries. With this approach, we find it unnecessary to create trifurcations if the primary site is larynx and hypopharynx. Its surgical technique, advantages and disadvantages are discussed.