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Sensory preservation in neck dissection: outcomes of a sub-sternocleidomastoid approach.

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Title: Sensory preservation in neck dissection: outcomes of a sub-sternocleidomastoid approach.
Authors: Honda, Keigo, Asato, Ryo, Tsuji, Jun, Miyazaki, Masakazu, Kada, Shinpei, Kataoka, Yukiko, Taura, Akiko, Morita, Mami
Source: Acta Oto-Laryngologica. Aug2018, Vol. 138 Issue 8, p763-767. 5p.
Subjects: Sternocleidomastoid muscle, Neck tumors, Anesthesia, Head tumors, Neck surgery, Postoperative period, Senses, Submandibular gland, Retrospective studies, Cervical plexus, Physiology, Surgery
Abstract: Objective: Cutaneous anesthesia in early postoperative period is common after neck dissection even if the cervical nerve (CN) rootlets are preserved. The aim of this study was to evaluate if the preservation of the terminal branches of CNs using sub-sternocleidomastoid (SCM) approach combined with medially placed skin incision can prevent early postoperative anesthesia. Material and methods: A retrospective chart review was performed on 129 neck dissections in 87 head and neck cancer patients. Results: The early postoperative sensory preservation rates for the ear tab, submandibular, lateral neck, and sub-clavicular areas of CN rootlet-preserved necks (n = 86) were 75.6%, 20.9%, 74.4%, and 86.0%, respectively, compared with 37.2%, 2.3%, 2.3%, and 4.7%, respectively, in CN rootlet-resected necks (n = 43). In CN rootlet-preserved necks, the sub-SCM approach (n = 54) showed 81.5%, 27.8%, 92.6%, and 94.4% preservation rates, respectively, compared with 65.6%, 9.4%, 43.8%, and 71.9%, respectively, using the conventional subplatysmal approach (n = 32). The rates were significantly better in the submandibular, lateral neck, and sub-clavicular areas after sub-SCM approach. Conclusions: Preservation of CN rootlets is a required element for sensory preservation in neck dissection. The sub-SCM approach can effectively prevent early postoperative cutaneous anesthesia following CN-preserving neck dissection. [ABSTRACT FROM AUTHOR]
Copyright of Acta Oto-Laryngologica is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Label: Title
  Group: Ti
  Data: Sensory preservation in neck dissection: outcomes of a sub-sternocleidomastoid approach.
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  Data: <searchLink fieldCode="AR" term="%22Honda%2C+Keigo%22">Honda, Keigo</searchLink><br /><searchLink fieldCode="AR" term="%22Asato%2C+Ryo%22">Asato, Ryo</searchLink><br /><searchLink fieldCode="AR" term="%22Tsuji%2C+Jun%22">Tsuji, Jun</searchLink><br /><searchLink fieldCode="AR" term="%22Miyazaki%2C+Masakazu%22">Miyazaki, Masakazu</searchLink><br /><searchLink fieldCode="AR" term="%22Kada%2C+Shinpei%22">Kada, Shinpei</searchLink><br /><searchLink fieldCode="AR" term="%22Kataoka%2C+Yukiko%22">Kataoka, Yukiko</searchLink><br /><searchLink fieldCode="AR" term="%22Taura%2C+Akiko%22">Taura, Akiko</searchLink><br /><searchLink fieldCode="AR" term="%22Morita%2C+Mami%22">Morita, Mami</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22Acta+Oto-Laryngologica%22">Acta Oto-Laryngologica</searchLink>. Aug2018, Vol. 138 Issue 8, p763-767. 5p.
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  Data: <searchLink fieldCode="DE" term="%22Sternocleidomastoid+muscle%22">Sternocleidomastoid muscle</searchLink><br /><searchLink fieldCode="DE" term="%22Neck+tumors%22">Neck tumors</searchLink><br /><searchLink fieldCode="DE" term="%22Anesthesia%22">Anesthesia</searchLink><br /><searchLink fieldCode="DE" term="%22Head+tumors%22">Head tumors</searchLink><br /><searchLink fieldCode="DE" term="%22Neck+surgery%22">Neck surgery</searchLink><br /><searchLink fieldCode="DE" term="%22Postoperative+period%22">Postoperative period</searchLink><br /><searchLink fieldCode="DE" term="%22Senses%22">Senses</searchLink><br /><searchLink fieldCode="DE" term="%22Submandibular+gland%22">Submandibular gland</searchLink><br /><searchLink fieldCode="DE" term="%22Retrospective+studies%22">Retrospective studies</searchLink><br /><searchLink fieldCode="DE" term="%22Cervical+plexus%22">Cervical plexus</searchLink><br /><searchLink fieldCode="DE" term="%22Physiology%22">Physiology</searchLink><br /><searchLink fieldCode="DE" term="%22Surgery%22">Surgery</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Objective: Cutaneous anesthesia in early postoperative period is common after neck dissection even if the cervical nerve (CN) rootlets are preserved. The aim of this study was to evaluate if the preservation of the terminal branches of CNs using sub-sternocleidomastoid (SCM) approach combined with medially placed skin incision can prevent early postoperative anesthesia. Material and methods: A retrospective chart review was performed on 129 neck dissections in 87 head and neck cancer patients. Results: The early postoperative sensory preservation rates for the ear tab, submandibular, lateral neck, and sub-clavicular areas of CN rootlet-preserved necks (n = 86) were 75.6%, 20.9%, 74.4%, and 86.0%, respectively, compared with 37.2%, 2.3%, 2.3%, and 4.7%, respectively, in CN rootlet-resected necks (n = 43). In CN rootlet-preserved necks, the sub-SCM approach (n = 54) showed 81.5%, 27.8%, 92.6%, and 94.4% preservation rates, respectively, compared with 65.6%, 9.4%, 43.8%, and 71.9%, respectively, using the conventional subplatysmal approach (n = 32). The rates were significantly better in the submandibular, lateral neck, and sub-clavicular areas after sub-SCM approach. Conclusions: Preservation of CN rootlets is a required element for sensory preservation in neck dissection. The sub-SCM approach can effectively prevent early postoperative cutaneous anesthesia following CN-preserving neck dissection. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of Acta Oto-Laryngologica is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
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      – Type: doi
        Value: 10.1080/00016489.2018.1455008
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      – Code: eng
        Text: English
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      Pagination:
        PageCount: 5
        StartPage: 763
    Subjects:
      – SubjectFull: Sternocleidomastoid muscle
        Type: general
      – SubjectFull: Neck tumors
        Type: general
      – SubjectFull: Anesthesia
        Type: general
      – SubjectFull: Head tumors
        Type: general
      – SubjectFull: Neck surgery
        Type: general
      – SubjectFull: Postoperative period
        Type: general
      – SubjectFull: Senses
        Type: general
      – SubjectFull: Submandibular gland
        Type: general
      – SubjectFull: Retrospective studies
        Type: general
      – SubjectFull: Cervical plexus
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      – SubjectFull: Physiology
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      – SubjectFull: Surgery
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              Text: Aug2018
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