Qian Cai1, Yong Pan2, Yaodong Xu2, Faya Liang2, Xiaoming Huang2, Xiaoyu Jiang2, Ping Han2. 1. Department of Otolaryngology-Head and Neck, Affiliated Second Hospital, Sun Yat-sen University, China. Electronic address: caiq163@126.com. 2. Department of Otolaryngology-Head and Neck, Affiliated Second Hospital, Sun Yat-sen University, China.
Abstract
OBJECTIVES: This study explores application of selective neck dissection technique in recurrent second, third, and fourth branchial cleft deformities. METHODS: A total of 19 cases of recurrent second, third, and fourth branchial cleft deformities were treated using the selective neck dissection technique, during which the sternocleidomastoid muscle, cervical anterior muscle, and carotid sheath were contoured. The lesion above the prevertebral fascia was then resected en bloc. Finally, the opening of the internal fistula was ligated and sutured using the purse-string approach. RESULTS: Patients in this study had no injures to their internal carotid artery, jugular vein, vagus nerve, accessory nerve, hypoglossal nerve, or recurrent laryngeal nerve. There were also no complications such as poor wound healing. The patients were monitored for 7-73 months and showed no recurrences. CONCLUSIONS: Using selective neck dissection to treat second, third, and fourth branchial cleft deformities resulted in en bloc lesion resections and reduced the chance of recurrence. Contouring the sternocleidomastoid muscle, strap muscle, and carotid sheath is key to the surgical procedure, as it leads to en bloc lesion resection while retaining the recurrent laryngeal nerve and carotid sheath.
OBJECTIVES: This study explores application of selective neck dissection technique in recurrent second, third, and fourth branchial cleft deformities. METHODS: A total of 19 cases of recurrent second, third, and fourth branchial cleft deformities were treated using the selective neck dissection technique, during which the sternocleidomastoid muscle, cervical anterior muscle, and carotid sheath were contoured. The lesion above the prevertebral fascia was then resected en bloc. Finally, the opening of the internal fistula was ligated and sutured using the purse-string approach. RESULTS:Patients in this study had no injures to their internal carotid artery, jugular vein, vagus nerve, accessory nerve, hypoglossal nerve, or recurrent laryngeal nerve. There were also no complications such as poor wound healing. The patients were monitored for 7-73 months and showed no recurrences. CONCLUSIONS: Using selective neck dissection to treat second, third, and fourth branchial cleft deformities resulted in en bloc lesion resections and reduced the chance of recurrence. Contouring the sternocleidomastoid muscle, strap muscle, and carotid sheath is key to the surgical procedure, as it leads to en bloc lesion resection while retaining the recurrent laryngeal nerve and carotid sheath.
Authors: K Swetha; Satish Nair; K V R Brijith; J G Aishwarya; Y S Nagamani; Himani Indeewar Journal: Indian J Otolaryngol Head Neck Surg Date: 2018-05-05
Authors: Giovanni Di Nardo; Valentino Valentini; Diletta Angeletti; Simone Frediani; Giannicola Iannella; Denis Cozzi; Mario Roggini; Giuseppe Magliulo Journal: SAGE Open Med Case Rep Date: 2016-10-13