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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 Koh  ;  Eun Chang Choi 
 ANNALS OF SURGICAL ONCOLOGY, Vol.20(3) : 891-898, 2013 
Journal Title
Issue Date
Adult ; Aged ; Carcinoma, Squamous Cell/pathology ; Carcinoma, Squamous Cell/surgery* ; Feasibility Studies ; Female ; Follow-Up Studies ; Free Tissue Flaps* ; Head and Neck Neoplasms/pathology ; Head and Neck Neoplasms/surgery* ; Humans ; Male ; Middle Aged ; Neck Dissection* ; Neoplasm Staging ; Postoperative Complications ; Prognosis ; Prospective Studies ; Reconstructive Surgical Procedures* ; Rhytidoplasty* ; Robotics*
Neck Dissection ; Free Flap ; Selective Neck Dissection ; Transoral Laser Microsurgery ; Oral Cavity Cancer
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.
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1. College of Medicine (의과대학) > Dept. of Plastic and Reconstructive Surgery (성형외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Otorhinolaryngology (이비인후과학교실) > 1. Journal Papers
Yonsei Authors
Kho, Yoon Woo(고윤우)
Kim, Won Shik(김원식)
Park, Young Min(박영민) ORCID logo https://orcid.org/0000-0002-7593-8461
Lew, Dae Hyun(유대현)
Yun, In Sik(윤인식) ORCID logo https://orcid.org/0000-0003-1103-7047
Lee, Dong Won(이동원) ORCID logo https://orcid.org/0000-0003-0046-3139
Lee, Won Jai(이원재) ORCID logo https://orcid.org/0000-0003-3056-0503
Choi, Eun Chang(최은창)
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