Modification of the conley incision for neck dissection

Abstract

Objective : To describe a modified incision for neck dissection that makes the operation easier and provides good healing of the skin flaps and a cosmetic result in irradiated oral cancer patients. Materials and Methods : Twenty-three oral cancer patients, treated previously with radiotherapy, developed metastatic disease in the neck requiring radical neck dissection. In 12 of these patients radical neck dissection was performed using conventional incisions such as: the Y incision (5 patients), classic Conley incision (6 patients), and McFee incision (1 patient). In the remaining 11 patients a modified Conley incision was used. This modified incision was compared with the conventional incisions using as criteria adequacy of surgical access, healing of the skin flaps, and the cosmetic result. Results : In three of five patients (60%) treated with the Y incision there were complications involving early postoperative marginal necrosis of the skin flaps. The other 20 patients had normal healing and no necrosis or other complications were noted. Conclusion : According to our experience, we believe that the modified Conley incision in irradiated neck areas in oral cancer patients can be very useful because it is easy to perform and fulfills all the requirements for a radical neck dissection incision: adequate surgical access, good healing of skin flaps, and an acceptable cosmetic result.