The endoscopic approach to the neck: a review of the literature, and overview of the various techniques.
BACKGROUND
The endoscopic surgical approach to the neck has reached the head and neck surgeons' view with a certain delay, compared to other fields of endoscopic procedures. This may be attributed to the tight work space and plenty of vital structures in the operating field. Since study groups described first attempts with endoscopic or video assisted removals of thyroid glands in the late nineties, selective neck dissections on animal models or cadaveric dissections were performed in 2003.


METHODS
The review consists of a Medline Search regarding the terms of endoscopic, video- assisted neck dissections, excision of neck lesions, thyroidectomy and submandibular resection and minimal access surgery. The three main procedures (selective neck dissection, submandibular resection and thyroidectomy) are described and reviewed in the following test.


RESULTS
Various techniques have been performed successfully and led to good clinical results. The studies described in literature other than for thyroidectomy often do not exceed the level of small series or case-reports.


CONCLUSIONS
With a good proof of indication gasless lifting techniques, video assisted endoscopical techniques and subcutaneous approaches with gas filling procedures are feasible in neck surgery. All methods depending on the surgeons' experience describe no significantly extended operation times, a better and faster wound-healing and an optimized cosmetic outcome, compared to open approaches. Surgeons should always be aware of the limitations of the minimal invasive techniques regarding the complications or modifications during neck dissection/thyroidectomy.
Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany. amuenscher@uke.uni-hamburg.de
Adrian
A
Muenscher
Carsten
C
Dalchow
Hannes
H
Kutta
Rainald
R
Knecht
D000818:Animals; D004724:Endoscopy / Q000379:methods*; D006801:Humans; D019060:Minimally Invasive Surgical Procedures; D009333:Neck / Q000601:surgery*; D037981:Neck Dissection / Q000379:methods; D012371:Robotics; D013363:Submandibular Gland / Q000601:surgery; D013965:Thyroidectomy / Q000379:methods; D020535:Video-Assisted Surgery / Q000379:methods