Robotic Selective Neck Dissection by a Postauricular Facelift Approach: Comparison with Conventional Neck Dissection

Abstract

OBJECTIVES: The aim of this study was to investigate the feasibility and efficacy of robot-assisted neck dissection by a postauricular facelift approach in head and neck squamous cell carcinoma (HNSCC), compared with conventional neck dissection. STUDY DESIGN: Case series with chart review. SETTING: University tertiary care hospital. SUBJECTS AND METHODS: Thirty HNSCC patients with clinically node negative necks (cN0) who underwent robot-assisted selective neck dissection (SND) by a postauricular facelift approach (11 patients, 12 necks) or conventional neck dissection (19 patients, 21 necks). RESULTS: The mean age was lower in the robotic group (P = .030). However, the distributions of gender and TNM stage did not differ between the two groups. The robotic SND was completed successfully in all patients. The mean operative time was longer in the robotic group (215 ± 56 min) than the conventional group (144 ± 43 min) (P < .001). The mean numbers of lymph nodes removed were 25.0 ± 7.4 and 28.9 ± 8.2 in the robotic and conventional group, respectively (P = .192), and the number of lymph nodes removed at each level also did not differ between the 2 groups. In addition, there was no significant difference in postoperative complications between the 2 groups, but cosmetic satisfaction was higher in the robot group (P = .002). CONCLUSIONS: Robot-assisted SND by a postauricular facelift approach is comparable to conventional neck dissection in selected patients with cN0 HNSCC and results in excellent postoperative cosmesis.