Esthetic neck dissection using an endoscope via retroauricular incision: a report of two cases
A 63-year-old male patient visited the Department of Oral and Maxillofacial Surgery at Dental Hospital of Yonsei University of College of Dentistry in Korea. His chief complaint was an unhealed oral ulceration which appeared 8 months prior. Incisional biopsy had been performed by another hospital, which revealed invasive squamous cell carcinoma. The patient also had hypertension, for which he was receiving medication. He smoked two cigarettes a day for more than 30 years. The ulcerative lesion was present on the lingual side of #36, #37 and was 3.0×2.0 cm in size. The lesion had an irregular margin without bleeding tendency. Additional diagnostic imaging, including magnetic resonance imaging (MRI) and positron-emission tomography (PET), were performed to determine extent of surgery. There was no mandibular or metastatic lymph node invasion, nor were there metastatic lesions on any other organs (cT2N0M0, stage II). Thus, wide excision with marginal mandibulectomy, selective neck dissection (SND) (I-III) via endoscope, and repair of the soft tissue defect with Megaderm (L&C Bio, Seongnam, Korea) were performed.\nIt took almost 5 hours to complete endoscope-assisted SND (I-III), with 450 cc of blood loss during the operation. The final diagnosis confirmed the initial clinical staging (pT2N0M0, stage II). There was mild marginal mandibular branch weakness, which might also have arisen in conventional ND. The patient was discharged 13 days after surgery without any other complications.