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Roh JL. Scarless Excision of Second Branchial Cleft Cyst via Retroauricular Hairline Incision. Aesthetic Plast Surg 2024; 48:1264-1270. [PMID: 38097689 DOI: 10.1007/s00266-023-03770-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 11/17/2023] [Indexed: 04/24/2024]
Abstract
BACKGROUND Second branchial cleft cyst (2nd BCC) is treated by complete excision. Conventional transcervical skin incision on the lesion may leave a prominent scar in the cosmetically sensitive area. The retroauricular hairline incision (RAHI) approach may maintain neurological, mobility, and cosmetic functions of the neck and face after excision. This study evaluated the clinical outcomes and disease control of scarless surgery via RAHI in 57 consecutive patients with 2nd BCC. METHODS The patients received the prospective evaluation of postoperative neurological, subjective pain, swallowing, neck motion, and cosmetic functions. Postoperative complications, subjective satisfaction, and recurrence were also assessed in each patient. RESULTS Excision was performed in all cases without injury to the facial nerve or other neurological complications and conversion to other incisions or approaches with a median operation time of 44 min. Complications were minimal, without dysphagia, neurological deficits, or limited neck motion. Postoperative incision scars in the postauricular and hairline region were commonly invisible. Subjective satisfaction with the scar and facial deformity was high after surgery. No patients had a recurrence for a median follow-up of 66 months. CONCLUSION The RAHI approach for 2nd BCC has excellent cosmetic, functional, and disease control outcomes. This can be safely applied to the treatment of 2nd BCC. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Jong-Lyel Roh
- Department of Otorhinolaryngology-Head and Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Gyeonggi-do, 13496, Republic of Korea.
- Department of Biomedical Science, General Graduate School, CHA University, Seongnam, Republic of Korea.
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Ohta N, Suzuki T, Noguchi N, Shirane S, Ansai N, Sato T, Ishida Y, Murakami K, Murakami K, Nakamura Y. A facelift procedure for resection of a branchial cleft cysts. Auris Nasus Larynx 2023; 50:272-275. [PMID: 35842275 DOI: 10.1016/j.anl.2022.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 06/24/2022] [Accepted: 06/30/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Branchial cleft cysts (BCCs) are common in daily practice, however, BCC patients suffer aesthetic problems due to postoperative scars on visible parts after surgery. To analyze the feasibility, surgical outcomes and possible risks and complications encountered during a facelift procedure for patients with BCC. METHODS This retrospective analysis examined patients who had undergone surgery for branchial cleft cyst using a facelift procedure (n = 16) or conventional transcervical resection (n = 20) at our institutes between April 2015 and August 2021. RESULTS There was no significant difference between the groups that underwent the facelift procedure or conventional transcervical resection as to the average size of the cysts, operating time, bleeding, drain out, or recurrence. None of the patients needed to switch from the facelift procedure to conventional transcervical resection. In all the patients in the facelift procedure group, postoperative scars were fully concealed by the auricle and hair. However, four patients in the facelift procedure group experienced a transient auricular complication after surgery. CONCLUSION The facelift procedure provides adequate visualization, workspace and excellent cosmetic results in suitably selected cases with BCC.
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Affiliation(s)
- Nobuo Ohta
- Division of Otolaryngology, Tohoku Medical and Pharmaceutical University Hospital, 1-12-1, Fukumuro, Miyaginoku, Sendai 983-8512, Japan; Department of Otolaryngology, Yamagata City Hospital Saiseikan, Yamagata, Japan.
| | - Takahiro Suzuki
- Division of Otolaryngology, Tohoku Medical and Pharmaceutical University Hospital, 1-12-1, Fukumuro, Miyaginoku, Sendai 983-8512, Japan
| | - Naoya Noguchi
- Division of Otolaryngology, Tohoku Medical and Pharmaceutical University Hospital, 1-12-1, Fukumuro, Miyaginoku, Sendai 983-8512, Japan
| | - Shion Shirane
- Division of Otolaryngology, Tohoku Medical and Pharmaceutical University Hospital, 1-12-1, Fukumuro, Miyaginoku, Sendai 983-8512, Japan
| | - Nanako Ansai
- Division of Otolaryngology, Tohoku Medical and Pharmaceutical University Hospital, 1-12-1, Fukumuro, Miyaginoku, Sendai 983-8512, Japan
| | - Teruyuki Sato
- Division of Otolaryngology, Tohoku Medical and Pharmaceutical University Hospital, 1-12-1, Fukumuro, Miyaginoku, Sendai 983-8512, Japan
| | - Yusuke Ishida
- Division of Anatomy and Cell Biology, Tohoku Medical and Pharmaceutical University, 1-12-1, Fukumuro, Miyaginoku, Sendai 983-8512, Japan
| | - Keigo Murakami
- Division of Pathology, Tohoku Medical and Pharmaceutical University, 1-12-1, Fukumuro, Miyaginoku, Sendai 983-8512, Japan
| | - Kazuhiro Murakami
- Division of Pathology, Tohoku Medical and Pharmaceutical University, 1-12-1, Fukumuro, Miyaginoku, Sendai 983-8512, Japan
| | - Yasuhiro Nakamura
- Division of Pathology, Tohoku Medical and Pharmaceutical University, 1-12-1, Fukumuro, Miyaginoku, Sendai 983-8512, Japan
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Postauricular Incision Versus Conventional Transcervical Incision in Second Branchial Cleft Cyst Excision: A Systematic Review and Meta-Analysis. J Craniofac Surg 2022; 33:2365-2371. [PMID: 35882056 PMCID: PMC9612730 DOI: 10.1097/scs.0000000000008741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 03/30/2022] [Indexed: 11/26/2022] Open
Abstract
Surgical removal is the treatment of choice for second branchial cleft cysts (SBCCs), which are congenital anomalies. The conventional procedure is performed through a transcervical approach, which would lead to a visible scar in the anterior neck. Conversely, the postauricular approach could keep the scar in the hairline or retroauricular sulcus, rendering it almost invisible after the surgery. The purpose of this meta-analysis was to evaluate the differences between the postauricular and conventional transcervical approaches to SBCC excision. A systematic review was performed using PubMed, Embase, and the Cochrane Library to identify studies comparing outcomes of SBCC surgery via postauricular and conventional transcervical approaches. The data of interest were analyzed with Comprehensive Meta-Analysis software (version 3). The data of interest were analyzed by calculating the risk difference (RD), the standardized mean difference, and the mean difference (MD) with the 95% confidence interval (CI). Three studies were eligible for the final analysis. The pooled analysis demonstrated that the cosmetic satisfaction score was significantly higher with the postauricular approach (standardized mean difference, 2.12; 95% CI, 0.68–3.56). The operative duration was significantly longer with the postauricular approach than with the conventional transcervical approach (MD, 12.81; 95% CI, 2.39–23.23). The incidences of postoperative marginal mandibular nerve palsy (RD, 0.00; 95% CI, −0.09 to 0.09), bleeding complications (RD, −0.02; 95% CI, −0.09 to 0.05), salivary complications (RD, −0.00; 95% CI, −0.07 to 0.06), cyst size (MD, 0.02; 95% CI, −0.96–0.99), and length of hospital stay (MD, −2.50; CI, −7.30 to 2.30) were comparable between the 2 groups. The postauricular approach is feasible for use in SBCC excision and yields better cosmetic outcomes, a longer operative duration, and a similar rate of complications.
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Meijers S, Meijers R, van der Veen E, van den Aardweg M, Bruijnzeel H. A Systematic Literature Review to Compare Clinical Outcomes of Different Surgical Techniques for Second Branchial Cyst Removal. Ann Otol Rhinol Laryngol 2021; 131:435-444. [PMID: 34137276 PMCID: PMC8899809 DOI: 10.1177/00034894211024049] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Objective: During the last 2 decades, new treatment methods have been developed for the
surgical removal of second branchial cysts which result in less visible
scars. The aim of this systematic review is to assess which surgical
technique for second branchial arch cyst removal results in the lowest
complication and recurrence rates with the highest scar satisfaction. Methods: Two authors systematically reviewed the literature in the Cochrane, PubMed,
and EMBASE databases (search date: 1975 to December 2nd, 2020) to identify
studies comparing surgical outcomes of second branchial arch cyst removal.
Authors appraised selected studies on directness of evidence and risk of
bias. Results are reported according to Preferred Reporting Items for
Systematic Reviews and Meta-Analyses statement. Results: Out of the 2442 retrieved articles, 4 articles were included in the current
review including a total of 140 operated cysts. Only 2 studies included
pre-operatively infected cysts. Follow up ranged from 3 to 24 months.
Complication rates ranged from 0 to 27.3% (conventional: [0–10.4%];
endoscopic/retro-auricular: [0–27.3%]). None of the patients presented with
postoperative recurrence. Significantly higher scar satisfaction was found
in adult patients who underwent endoscopic or retro-auricular hairline
incision cyst removal. Conclusion: No recurrence of disease occurred during (at least) 3 months of follow up
using either conventional surgery or endoscopic/retro-auricular techniques.
Although more (temporary) complications occur using endoscopic and
retro-auricular techniques, patients report a significantly higher scar
satisfaction 3 to 6 months after surgery in comparison to the conventional
technique. Future studies are needed to support these findings.
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Affiliation(s)
- Sebastiaan Meijers
- Department of Otorhinolaryngology and
Head and Neck Surgery, University Medical Center Utrecht, the Netherlands
| | - Rutger Meijers
- Department of Neurology, Radboud
University Medical Center, Nijmegen, The Netherlands
| | - Erwin van der Veen
- Department of Otorhinolaryngology and
Head and Neck Surgery, University Medical Center Utrecht, the Netherlands
- Central Military Hospital, Utrecht, The
Netherlands
| | - Maaike van den Aardweg
- Department of Otorhinolaryngology and
Head and Neck Surgery, Rivierenland Hospital, Tiel, The Netherlands
| | - Hanneke Bruijnzeel
- Department of Otorhinolaryngology and
Head and Neck Surgery, University Medical Center Utrecht, the Netherlands
- Brain Center Rudolf Magnus, Utrecht,
The Netherlands
- Hanneke Bruijnzeel, MD, PhD, Department of
Otolaryngology and Head and Neck Surgery, Utrecht Medical Center, Heidelberglaan
100, Utrecht 3584 CX, The Netherlands.
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