Objectives/Hypothesis: Benign neck masses are usually found in younger patients, who are more likely to be concerned about postoperative scars. Until recently, a direct approach through a transcervical incision along the mass has been accepted as a standard surgical procedure for the benign neck mass. However, this conventional transcervical approach leaves a visible scar on the neck, regardless of the size of the incision. We assumed that an endoscopic gasless axillo-breast (A-B) approach might be a good alternative method for excision of benign neck masses. The aim of this study was to determine the safety and feasibility of a gasless A-B approach for the excision of benign neck masses by comparing it to the conventional open approach. Study Design: Case series. Methods: We prospectively compared the outcomes of endoscopic removal of benign neck lesions with the outcomes of conventional open surgery. Results: Most patients in the endoscopy group were women, and the mean age was younger than in the open group. Although operative time was longer and amount of drainage was larger in the endoscopy group, there was no statistically significant difference in duration of drainage, hospitalization period, complication rate, and pain score. Endoscopically treated patients were more satisfied with the cosmetic outcome of the surgery than patients in the conventional open group. Conclusions: Endoscopic excision via an A-B approach without gas insufflation could be a good substitute for conventional transcervical excision in selected cases of benign neck lesion.
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