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Head and Neck Surgery

Free-Flap Reconstruction After Robotic Neck Dissection via Retroauricular Approach

Sunday, October 1, 2023
3:45 PM - 3:51 PM East Coast USA Time
Location: 201AB

    Co-Author(s)

  • NS

    Nam Suk Sim, MD

    Yonsei College of Medicine
    Seoul, USA

    • Presenting Author(s)

  • Hyun Jun HONG, MD

    Professor
    Yonsei University College of Medicine
    Seoul, Seoul-t'ukpyolsi, Republic of Korea

    • Co-Author(s)

  • DK

    Da hee Kim, MD

    Yonsei college of medicine, USA

  • EC

    Eun Chang Choi, MD, PhD

    Professor and Chairman
    Yonsei University
    Seoul, South Korea

    • Senior Author(s)

  • Yoon Woo Koh, MD, PhD

    Professor
    Department of Otorhinolaryngology, Yonsei University College of Medicine
    Seoul, Seoul-t'ukpyolsi, Republic of Korea

Disclosure(s):
Hyun Jun HONG, MD: No relevant relationships to disclose.
Introduction: With the advent of Da Vinci robotic technique, robotic neck dissection via retro-auricular(RA) approach has a great advantage of being scarless and precise surgery possible. However, since head and neck cancer often requires free flap reconstruction, real world data on free flap reconstruction via RA approach are needed. Here, we described our experience with more than 100 cases of free flap reconstruction after robotic neck dissection via RA approach.

Methods: From July 2011 to December 2022, we analyzed total 128 patients who had undergone free flap reconstruction after robotic neck dissection via RA approach at a Severance hospital, south korea.

Results: Of the total 128 patients, 86 cases were oral cavity cancer, 29 cases were oropharyngeal cancer, nine cases were hypopharyngeal cancer, and four cases were larynx or major salivary gland cancer. 57 cases used radial forearm free flap (RFFF, 44.5%), 67 cases applied anterolateral thigh (ALT, 52.3%) flap and four cases were fibular free flap (3.1%). In cases of oral cavity cancer, free flap using ALT were the most cases: 50 of ALT, 32 of RFFF, and 4 of fibular free flap. Re-operation for reasons such as venous congestion or arterial insufficiency were performed in 7 cases (8.1%). For oropharyngeal cancer, fourteen cases used ALT, and fifteen cases applied RFFF. Re-operation were undergone in 6 patients for necrosis or wound problem(20.7%). Three patients were expired due to bleeding events(10.3%). Among the patients with hypopharyngeal cancer, two cases used ALT and seven cases applied RFFF. Two cases of pharyngo cutaneous fistula(22.2%) was noted and 4 cases showed esophageal stricture(44.4%). For laryngeal or major salivary gland cancer, one case for SMG cancer used ALT. The other three cases applied RFFF. No post-operative complication was reported.

Conclusions: Free flap reconstruction after robotic neck dissection via RA approach showed favorable surgical outcome. These results suggest that robotic neck dissection via retro-auricular approach could be the worthwhile option for patients in need of free flap reconstruction.