Robot-Assisted Selective Neck Dissection of Levels II to V via a Modified Facelift or Retroauricular Approach

• Published in: Otolaryngology-head and neck surgery 2013-05, Vol.148 (5), p.778-785
• Main Authors: Park, Young Min, Holsinger, F. Christopher, Kim, Won Shik, Park, Sang Chul, Lee, Eun Jung, Choi, Eun Chang, Koh, Yoon Woo
• Format: Article
• Language: English
• Subjects: Aged; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - surgery; Feasibility Studies; Female; Humans; Laryngeal Neoplasms - pathology; Laryngeal Neoplasms - surgery; laryngopharyngeal cancer; Lymph Nodes - pathology; Lymph Nodes - surgery; Lymphatic Metastasis; Male; Middle Aged; modified facelift approach; Neck - surgery; Neck Dissection - methods; Pharyngeal Neoplasms - pathology; Pharyngeal Neoplasms - surgery; retroauricular approach; Robotics; robot‐assisted selective neck dissection; transoral robotic surgery; Treatment Outcome
• ISSN: 0194-5998; 1097-6817
• DOI: 10.1177/0194599813478934

Objectives We performed robot-assisted selective neck dissection via a modified facelift or retroauricular approach without creating an apparent scar around the neck to remove neck node of levels II to V after transoral robotic surgery of a primary lesion in patients with laryngopharyngeal carcinoma. Patient data were prospectively analyzed to verify the feasibility and efficacy of robot-assisted neck dissection in the treatment of cN0 laryngopharyngeal carcinoma. Study Design Prospective case series. Setting University tertiary care facility. Subjects and Methods Between March 2011 and March 2012, 7 patients were enrolled in the study. Before study initiation, the Institutional Review Board of Yonsei University approved the protocol, and informed consent was obtained from all patients. Results Robot-assisted neck dissection was successfully performed in all patients. Five patients underwent selective neck dissection including levels II to IV, and 2 patients underwent selective neck dissection including levels II to V. The average number of lymph nodes retrieved was 25.1. Occult nodal metastasis was found in 1 (14%) neck specimen. During the follow-up period (mean of 13.5 months), all patients were alive without locoregional recurrence. All patients were extremely satisfied with their cosmetic results. Conclusion Robot-assisted selective neck dissection is a feasible and safe technique to manage the neck in cN0 laryngopharyngeal carcinoma patients. It may be especially helpful for patients undergoing transoral robotic surgery since no apparent scar around the neck remains. Long-term results with respect to oncologic safety and functional outcomes are required to establish the validity of robot-assisted neck dissection.