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Med Oral Patol Oral Cir Bucal. 2023 Jul 1;28(4):e378-e384. doi: 10.4317/medoral.25802.
This study aims to propose a lateral cervical stria approach for selective neck dissection (SND) in patients of early-stage oral malignancies.
The lateral cervical stria approach was used in 11 patients undergoing SND between December 2020 and March 2022. The surgical incision was located in submandibular cervical stria, with a length of 5.0 cm. The ipsilateral SND was performed according to the pathological type, covering part or all of I-V levels. Perioperative variables including operation time, blood loss, drainage volume, number of lymph node as well as complications were assessed. The score of appearance using the University of Washington Quality of Life Questionnaire (UW-QOL) was recorded 6-month postoperatively.
Direct closure of primary lesion was performed in ten patients and a forearm free flap reconstruction was used in one patient. No wound breakdown or infection was found in all cases. The mean operative time of SND was 157.63±27.39 min. The volume of intraoperative blood loss and postoperative drainage was 120.45±36.77 ml and 314.09±98.82 ml, respectively. The mean number of retrieved lymph nodes was 17.89±6.03 (ranging from 12 to 31). Postoperative complications included mild static lower lip deviation (n=1), shoulder discomfort (n=1) and mild auricular paraesthesia (n=1). The mean score of appearance was 86.36±13.06, with 100 scores in 5 patients and 75 scores in 6 patients.
The lateral cervical stria approach for SND in early-stage oral malignancies is reliable, achieving to satisfactory functional and aesthetic outcomes.
本研究旨在提出一种颈侧纹 approach 用于选择性颈清扫术(SND)在早期口腔恶性肿瘤患者中。
2020 年 12 月至 2022 年 3 月,11 例患者采用颈侧纹 approach 行 SND。手术切口位于颌下颈纹,长 5.0cm。根据病理类型行同侧 SND,覆盖 I-V 级部分或全部。评估围手术期变量,包括手术时间、出血量、引流量、淋巴结数量和并发症。术后 6 个月采用华盛顿大学生活质量问卷(UW-QOL)记录外观评分。
10 例患者直接闭合原发病灶,1 例患者采用游离前臂皮瓣重建。所有病例均未发现伤口破裂或感染。SND 的平均手术时间为 157.63±27.39min。术中出血量和术后引流量分别为 120.45±36.77ml 和 314.09±98.82ml。平均淋巴结检出数为 17.89±6.03(12-31 个)。术后并发症包括轻度静态下唇偏斜(n=1)、肩部不适(n=1)和轻度耳后感觉异常(n=1)。外观评分平均为 86.36±13.06,5 例患者得 100 分,6 例患者得 75 分。
颈侧纹 approach 用于早期口腔恶性肿瘤的 SND 是可靠的,可获得满意的功能和美学效果。