A Study Comparing Free-Flap Reconstruction via the Retroauricular Approach and the Traditional Transcervical Approach for Head and Neck Cancer

A Matched Case–Control Study

Won Shik Kim, Jae Hong Park, Hyung Kwon Byeon, Jae Won Chang, Myung Jin Ban, Yoonwoo Koh, Eun Chang Choi

Research output: Contribution to journalArticle

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Abstract

Background: Free-flap reconstruction via a retroauricular approach (RRA) after robot-assisted neck dissection (RAND) could have cosmetic benefits. This study aimed to compare the surgical outcomes of free-flap reconstruction via a RRA and via a transcervical approach in head and neck cancer. Methods: For this matched case–control study, 50 patients with head and neck cancer requiring free-flap reconstruction were divided into two groups: those reconstructed via a RRA group and those reconstructed via a transcervical approach (RTA group). The total operation time for free-flap reconstruction, the flap survival rate, the length of the hospital stay, the complications, and the scar satisfaction scores were compared between the two groups. Results: The RRA group comprised 25 patients, and the RTA group had 25 patients. The mean operation time for reconstruction was 288 ± 77 min in the RRA group and 250 ± 98 min in the RTA group (p = 0.132). Flap failure occurred for two patients in the RRA group (8 %) and for one patient in the RTA group (4 %) (p = 1.000). The mean hospital stay was 21 ± 18 days in the RRA group and 23 ± 14 days in the RTA group (p = 0.669). The complications were comparable between the two groups. However, the overall scar satisfaction was significantly higher in the RRA group (p = 0.000). Conclusions: For patients with head and neck cancer, RRA has better cosmetic outcomes than RTA. The RRA approach could be used for select patients who undergo RAND and prefer to avoid a visible anterior neck scar.

Original languageEnglish
Pages (from-to)349-354
Number of pages6
JournalAnnals of Surgical Oncology
Volume22
DOIs
Publication statusPublished - 2015 Dec 1

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Free Tissue Flaps
Head and Neck Neoplasms
Cicatrix
Length of Stay
Neck Dissection
Cosmetics
Neck
Survival Rate

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

Cite this

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title = "A Study Comparing Free-Flap Reconstruction via the Retroauricular Approach and the Traditional Transcervical Approach for Head and Neck Cancer: A Matched Case–Control Study",
abstract = "Background: Free-flap reconstruction via a retroauricular approach (RRA) after robot-assisted neck dissection (RAND) could have cosmetic benefits. This study aimed to compare the surgical outcomes of free-flap reconstruction via a RRA and via a transcervical approach in head and neck cancer. Methods: For this matched case–control study, 50 patients with head and neck cancer requiring free-flap reconstruction were divided into two groups: those reconstructed via a RRA group and those reconstructed via a transcervical approach (RTA group). The total operation time for free-flap reconstruction, the flap survival rate, the length of the hospital stay, the complications, and the scar satisfaction scores were compared between the two groups. Results: The RRA group comprised 25 patients, and the RTA group had 25 patients. The mean operation time for reconstruction was 288 ± 77 min in the RRA group and 250 ± 98 min in the RTA group (p = 0.132). Flap failure occurred for two patients in the RRA group (8 {\%}) and for one patient in the RTA group (4 {\%}) (p = 1.000). The mean hospital stay was 21 ± 18 days in the RRA group and 23 ± 14 days in the RTA group (p = 0.669). The complications were comparable between the two groups. However, the overall scar satisfaction was significantly higher in the RRA group (p = 0.000). Conclusions: For patients with head and neck cancer, RRA has better cosmetic outcomes than RTA. The RRA approach could be used for select patients who undergo RAND and prefer to avoid a visible anterior neck scar.",
author = "Kim, {Won Shik} and Park, {Jae Hong} and Byeon, {Hyung Kwon} and Chang, {Jae Won} and Ban, {Myung Jin} and Yoonwoo Koh and Choi, {Eun Chang}",
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A Study Comparing Free-Flap Reconstruction via the Retroauricular Approach and the Traditional Transcervical Approach for Head and Neck Cancer : A Matched Case–Control Study. / Kim, Won Shik; Park, Jae Hong; Byeon, Hyung Kwon; Chang, Jae Won; Ban, Myung Jin; Koh, Yoonwoo; Choi, Eun Chang.

In: Annals of Surgical Oncology, Vol. 22, 01.12.2015, p. 349-354.

Research output: Contribution to journalArticle

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T1 - A Study Comparing Free-Flap Reconstruction via the Retroauricular Approach and the Traditional Transcervical Approach for Head and Neck Cancer

T2 - A Matched Case–Control Study

AU - Kim, Won Shik

AU - Park, Jae Hong

AU - Byeon, Hyung Kwon

AU - Chang, Jae Won

AU - Ban, Myung Jin

AU - Koh, Yoonwoo

AU - Choi, Eun Chang

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N2 - Background: Free-flap reconstruction via a retroauricular approach (RRA) after robot-assisted neck dissection (RAND) could have cosmetic benefits. This study aimed to compare the surgical outcomes of free-flap reconstruction via a RRA and via a transcervical approach in head and neck cancer. Methods: For this matched case–control study, 50 patients with head and neck cancer requiring free-flap reconstruction were divided into two groups: those reconstructed via a RRA group and those reconstructed via a transcervical approach (RTA group). The total operation time for free-flap reconstruction, the flap survival rate, the length of the hospital stay, the complications, and the scar satisfaction scores were compared between the two groups. Results: The RRA group comprised 25 patients, and the RTA group had 25 patients. The mean operation time for reconstruction was 288 ± 77 min in the RRA group and 250 ± 98 min in the RTA group (p = 0.132). Flap failure occurred for two patients in the RRA group (8 %) and for one patient in the RTA group (4 %) (p = 1.000). The mean hospital stay was 21 ± 18 days in the RRA group and 23 ± 14 days in the RTA group (p = 0.669). The complications were comparable between the two groups. However, the overall scar satisfaction was significantly higher in the RRA group (p = 0.000). Conclusions: For patients with head and neck cancer, RRA has better cosmetic outcomes than RTA. The RRA approach could be used for select patients who undergo RAND and prefer to avoid a visible anterior neck scar.

AB - Background: Free-flap reconstruction via a retroauricular approach (RRA) after robot-assisted neck dissection (RAND) could have cosmetic benefits. This study aimed to compare the surgical outcomes of free-flap reconstruction via a RRA and via a transcervical approach in head and neck cancer. Methods: For this matched case–control study, 50 patients with head and neck cancer requiring free-flap reconstruction were divided into two groups: those reconstructed via a RRA group and those reconstructed via a transcervical approach (RTA group). The total operation time for free-flap reconstruction, the flap survival rate, the length of the hospital stay, the complications, and the scar satisfaction scores were compared between the two groups. Results: The RRA group comprised 25 patients, and the RTA group had 25 patients. The mean operation time for reconstruction was 288 ± 77 min in the RRA group and 250 ± 98 min in the RTA group (p = 0.132). Flap failure occurred for two patients in the RRA group (8 %) and for one patient in the RTA group (4 %) (p = 1.000). The mean hospital stay was 21 ± 18 days in the RRA group and 23 ± 14 days in the RTA group (p = 0.669). The complications were comparable between the two groups. However, the overall scar satisfaction was significantly higher in the RRA group (p = 0.000). Conclusions: For patients with head and neck cancer, RRA has better cosmetic outcomes than RTA. The RRA approach could be used for select patients who undergo RAND and prefer to avoid a visible anterior neck scar.

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