title: Neck dissection through a facelift incision.
abstract: OBJECTIVE
  To determine the feasibility and safety of neck dissection through a facelift incision.
  
  
  METHODS
  Prospective case series.
  
  
  METHODS
  Cadavers and live subjects underwent neck dissection using a facelift incision with and without endoscopic assistance. In the live facelift neck dissection (FLND), the preoperative surgical indications, staging, adjuvant therapy, intraoperative technical procedure, pathology reports on lymph nodes, and short-term outcomes were reviewed.
  
  
  RESULTS
  FLND was successfully performed in four cadavers and four live subjects, including selective (less than five neck levels removed) and comprehensive (levels I-V removed) neck dissections. All levels were accessible through this approach, with additional retraction required for levels I and IV. Endoscopic assistance was required in one neck dissection for adequate visualization. Short-term complications and number of excised lymph nodes were comparable to those from traditional neck dissection approaches.
  
  
  CONCLUSIONS
  Open neck dissection through a facelift incision is feasible and offers an alternate approach to traditional incisions. This can be performed without requiring robotic assistance and with endoscopic assistance only in certain cases. Endoscopic assistance can offer enhanced visualization of the surgical field and complement open direct approaches in neck dissection. Although FLND offers improved cosmetic outcomes when compared to those of traditional neck incisions, further study is required to determine its efficacy and indications.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
authors.forename: Thuy-Anh N
authors.initials: TA
authors.lastname: Melvin
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Eliades
authors.forename: Patrick K
authors.initials: PK
authors.lastname: Ha
authors.forename: Carole
authors.initials: C
authors.lastname: Fakhry
authors.forename: John M
authors.initials: JM
authors.lastname: Saunders
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Califano
authors.forename: Ray G F
authors.initials: RG
authors.lastname: Blanco
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy; D004724:Endoscopy / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods*; D011446:Prospective Studies; D015361:Rhytidoplasty; D012371:Robotics / Q000379:methods*; D014067:Tonsillar Neoplasms / Q000556:secondary* / Q000628:therapy