Technique of flap elevation for robot assisted selective neck dissection via retroauricular approach: a surgeon's guide.

Abstract

The retroauricular approach is being increasingly used in surgeries of head and neck in an attempt to avoid a disfiguring scar over the face or neck. The elevation of flap correctly is of paramount importance. The lateral to medial (vis-a vis posterior to anterior) approach can be challenging as the anatomical relations guiding the surgeon have a different orientation. The surgeons need to revisit the anatomy of the face and neck and identify reliable anatomical structures that will act as "new" landmarks to ensure proper dissection. 14 cases of robotic selective neck dissections and from January 2017 to January 2019 at Health Care Global Enterprises Ltd., Bangalore were included in the study. All the dissections were performed by a team of head and neck surgeon with experience in robotic surgery. In all the 14 cases, the step-wise surgical technique described was followed. One out of the 14 cases done had flap discolouration at the edge as it was thin. None of the patients had any wound dehiscence. This article tries to give a step to step description to enable the surgeon to raise the retroauricular flap safely and minimising the complications. Here, an attempt has been made to translate our experience to ensure standardisation of the technique with fewer complications.