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Updated: May 28, 2025

Gasless Endoscopic Thyroidectomy via the Trans-Axillary Approach
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Medial-to-Lateral Approach in Neck Dissection.

Keigo Honda1, Koichi Omori2, Atsushi Suehiro2

  • 1Department of Head and Neck Oncology and Innovative Treatment, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

Head & Neck
|February 10, 2025
PubMed
Summary

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Characteristics of parathyroid carcinoma: A descriptive study using administrative data in Japan.

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Novel Surgical Approach to Posterior Nasal Neurectomy without Identifying the Posterior Nasal Nerve.

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This video details a medial-to-lateral neck dissection for head and neck cancer, using the deep cervical fascia's middle layer as a landmark. This precise technique improves visualization and preserves vital cervical nerves during lymphatic tissue removal.

Area of Science:

  • Surgical Oncology
  • Head and Neck Surgery

Background:

  • Head and neck cancers require precise surgical management.
  • Neck dissections aim to remove cancerous lymph nodes while preserving critical structures.

Purpose of the Study:

  • To introduce and demonstrate a medial-to-lateral neck dissection technique.
  • To highlight the middle layer of the deep cervical fascia as a key surgical landmark.

Main Methods:

  • Systematic dissection from superficial lymphatic tissue (Paddle 1) to deeper planes (Paddles 2 and 3).
  • Emphasis on identifying and utilizing the middle layer of the deep cervical fascia.

Main Results:

  • Enhanced visualization of surgical planes.
  • Improved preservation of functionally important structures, including cervical nerves.
Keywords:
anatomymedial‐to‐lateral approachmiddle layer of deep cervical fascianeck dissectionpaddle concept

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  • Optimized removal of lymphatic tissue.

    • Conclusions:

    • The medial-to-lateral neck dissection technique offers enhanced precision.
    • This approach minimizes iatrogenic nerve damage.
    • It represents an effective strategy for head and neck cancer management.