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Evaluation of the optimal approach for endoscopic neck dissection using Thiel cadavers
Takashi Maruo1, Toshifumi Tomioka2, Wataru Okano2
1Department of Otolaryngology - Head and Neck Surgery, Jichi Medical University, School of Medicine, Japan.
Objective:
Endoscopic neck dissection (END) has been developed in Asia; however, it is necessary to validate a technique that has a short learning curve and is easy to introduce. The purpose of this study was to determine the approach with the easiest introduction and shortest learning curve using donated cadavers fixed with the Thiel method.
Methods:
A total of four different approaches were examined. Each approach was evaluated by a questionnaire administered to five head and neck surgeons, the extent of dissection was confirmed, and the number of dissected lymph nodes was counted.
Results:
Endoscopic supra-omohyoid-neck dissection (SOHND) by entering from the anterior margin of the sternocleidomastoid muscle (SCM) through a retroauricular (RA) approach was the most highly rated in the questionnaire, and the extent of dissection and number of lymph nodes dissected were reasonable in this study. Jugular neck dissection (JND) by entering the anterior margin of the SCM from the subclavian was the second highest scoring approach, but further advances in instrument development and technique are needed.
Conclusions:
Endoscopic SOHND by the RA approach was considered optimal. Endoscopic JND by the subclavian approach was the second most promising approach.
