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Lateral cervical approach for open laryngeal surgery: Technical notes.

Giuseppe Spriano1, Giuseppe Mercante2, Andrea Anelli2

  • 1Department of Otolaryngology Head and Neck Surgery Humanitas Clinical and Research Hospital, IRCCS Humanitas University, Milan, Italy.

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Summary

This study presents a minimally invasive lateral cervical approach for laryngectomy and neck dissection, preserving key muscles and the hyoid bone. The technique is safe and feasible for laryngeal cancer treatment.

Keywords:
laryngeal cancerlaryngectomylateral cervical approachminimally invasive surgery

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Area of Science:

  • Otolaryngology
  • Surgical Oncology

Background:

  • Transoral minimally invasive techniques aim to preserve healthy tissues in laryngeal cancer surgery.
  • The study addresses the need for minimally invasive approaches beyond transoral methods.

Purpose of the Study:

  • To describe a minimally invasive surgical procedure for laryngectomies with or without neck dissection.
  • To utilize a lateral cervical approach for improved tissue preservation.

Main Methods:

  • A lateral cervical incision is made along the sternocleidomastoid muscle.
  • An anterior myocutaneous (AMC) cervical flap is harvested, including skin, platysma, fascia superficialis, anterior jugular veins, and strap muscles.
  • Neck dissection and laryngectomy are performed simultaneously through the same incision, preserving supra-hyoid, sternohyoid, and homohyoid muscles, as well as the hyoid bone.

Main Results:

  • Open partial/total laryngectomies via a lateral cervical approach are feasible.
  • The AMC cervical flap facilitates simultaneous neck dissection and laryngeal specimen removal.
  • The procedure demonstrated safety in the described cases.

Conclusions:

  • The described lateral cervical approach is a safe and feasible minimally invasive technique for laryngectomy with or without neck dissection.
  • This method allows for simultaneous neck dissection and laryngeal specimen removal.
  • Preservation of supra-hyoid, sternohyoid, and homohyoid muscles, along with the hyoid bone, is achieved.