Free flap reconstruction after endoscopic and robotic neck dissection using retroauricular approach

Abstract

<h2>Unstructured Abstract</h2> The desire to reduce esthetic and psychological consequences following oncologic head and neck procedures has promoted the development of remote approaches to the neck. Within the last 10 y, the retroauricular approach has emerged as a feasible way to perform neck dissection and free-flap reconstruction. This was a retrospective analysis of a single-center experience and technical description. We included our early experience with the first eight cases performed by our group. No flap failures or other major complications were observed in this sample. In all of the cases, following robotic or endoscopic selective neck dissection, microvascular anastomosis was performed via a retroauricular approach with a self-retaining retractor to maintain an adequate working space and microscope assistance. Based on literature reports and our experience, robotic-assisted or endoscopic neck dissection via the retroauricular approach has a clear esthetic benefit and seems feasible and safe even when microvascular anastomosis is necessary for free-flap reconstruction in selected cases. <h3>Introduction</h3> Remote approaches to the neck following head and neck surgery have evolved and aim to reduce the aesthetic and psychological effects of surgery. In the last ten years, the retroauricular approach emerged as a feasible way to perform neck dissection and free-flap reconstruction. <h3>Methods</h3> Retrospective analysis of the experience and technical description in a single academic center. <h3>Results</h3> We included our early experience with the first 8 cases performed by our group. There were no flap failures or other major complications in this group. In all cases, following robotic or endoscopic selective neck dissection, microvascular anastomosis was performed via retro auricular approach. <h3>Conclusion</h3> Based on our experience and others described in the literature, the robotic-assisted or endoscopic neck dissection via the retroauricular approach has a clear aesthetic benefit. This technique is feasible and safe in select cases when microvascular anastomosis is performed for free-flap reconstruction.