Sawh-Martinez Rajendra, Douglas Stephanie, Pavri Sabrina, Ariyan Stephan, Narayan Deepak
From the Section of Plastic and Reconstructive Surgery, Department of Surgery, Yale University School of Medicine, New Haven, CT.
Ann Plast Surg. 2014 Dec;73 Suppl 2:S175-7. doi: 10.1097/SAP.0000000000000182.
We recently reported on the safety of minimally invasive parotid region sentinel node biopsy and level I-sparing radical neck dissection for head and neck melanoma. We therefore wished to assess the state of practice in the United States through a survey of specialists in head and neck surgery. We hypothesized that there would be significant variation in the management of these facets of head and neck melanoma. To test this hypothesis, a 10-question online survey on management of head and neck melanoma was distributed to the members of the American Head and Neck Society. Responses were matched to Internet Protocol addresses to ensure that each respondent completed the survey only once. Eighty-eight respondents completed the survey. For sentinel lymph nodes within the parotid gland, nearly half (47.7%) of surgeons surveyed perform a superficial parotidectomy, 13.6% perform a total parotidectomy, and only 38.6% perform parotid-sparing surgery; 71.6% of surgeons remove the submandibular nodes when carrying out a functional radical neck dissection. In conclusion, approaches to the management of head and neck melanoma vary widely, with only a minority of surgeons using morbidity-sparing surgical approaches. This study highlights the need for further randomized controlled trials in the surgical management of head and neck melanoma.
我们最近报道了微创腮腺区域前哨淋巴结活检及保留I区的根治性颈清扫术治疗头颈部黑色素瘤的安全性。因此，我们希望通过对头颈部外科专家的调查来评估美国的实际情况。我们假设头颈部黑色素瘤这些方面的治疗方法会存在显著差异。为验证这一假设，我们向美国头颈协会成员发放了一份关于头颈部黑色素瘤治疗的10个问题的在线调查问卷。将回复与互联网协议地址进行匹配，以确保每位受访者仅完成一次调查。88名受访者完成了调查。对于腮腺内的前哨淋巴结，近一半（47.7%）接受调查的外科医生进行浅叶腮腺切除术，13.6%进行全腮腺切除术，只有38.6%进行保留腮腺的手术；71.6%的外科医生在进行功能性根治性颈清扫术时会切除下颌下淋巴结。总之，头颈部黑色素瘤的治疗方法差异很大，只有少数外科医生采用降低发病率的手术方法。这项研究凸显了对头颈部黑色素瘤手术治疗进行进一步随机对照试验的必要性。
