Comparison of retroauricular and small transcervical approaches for endoscopic-assisted selective neck dissection: a cadaveric study

Advances in endoscopic-assisted neck surgery have allowed surgeons to conceal the scars via various approaches. However, studies comparing the approaches are still rare. The aim of this study was to comparatively analyze the feasibility and oncological outcomes of the retroauricular approach (RA) and the small transcervical approach (STC) for endoscopic-assisted selective neck dissection (EASND). Five fresh cadavers were recruited. EASND was performed via RA on one side and via STC on the contralateral side of each of the cadavers. The duration of the procedure was subdivided into preparation and EASND, and was recorded during the operation. The preserved vital structures were inspected by another surgeon after the cadaver dissection. The total number of lymph nodes retrieved was assessed by a pathologist. There was no significant difference in lymph node count between the RA group (mean 21, range 9–38) and the STC group (mean 23, range 7–34) (P > 0.05). The operation time was significantly longer in the RA group than in the STC group (preparation, P = 0.042; EASND, P = 0.043). In terms of surgical feasibility, STC can be chosen as the approach of choice for EASND. In spite of a long learning curve, RA might be an alternative option in particular cases to minimize scarring.