Faculty Opinions recommendation of Selective neck dissection as an early salvage intervention for clinically persistent nodal disease following chemoradiation.

Malignant tumours of the salivary glands in children are extremely rare. We present here a 12-year-old girl initially diagnosed as pleomorphic adenoma on fine needle aspiration biopsy, and adenoid cystic carcinoma (ACC) after the lesion was excised and examined by histopathology. A wide resection of the lesion and bilateral supraomyohyoid neck dissection was performed. To our knowledge this is one of the youngest patients with ACC of the minor salivary glands. Due to its benign histological appearance, the biological agressiveness of ACC is usually underestimated. Although fine needle aspiration cytology (FNAC) is very valuable in diagnosis, cytological variations of pleomorphic adenoma must be considered. ACC of the tongue in a young age group should be treated with wide resection and selective neck dissection if the tumour is localized in places where the risk of metastasis is increased and if there is a clinically palpable lymph node. In such cases the clinician should not avoid radical operations even in a young patient.

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Transection of Sternocleidomastoid for Selective Neck Dissection in Recurrent Papillary Thyroid Cancers

World Journal of Endocrine Surgery ◽

10.5005/jp-journals-10002-1205 ◽

2017 ◽

Vol 9 (1) ◽

pp. 32-34

Author(s):

Aromal Chekavar ◽

Sapana Bothra ◽

Mohammed Rashid ◽

Ashok Kumar Vema

Keyword(s):

Neck Dissection ◽

Nodal Metastasis ◽

Selective Neck Dissection ◽

Papillary Thyroid ◽

Reoperative Surgery ◽

Thyroid Cancers ◽

Posterior Triangle ◽

Positron Emission ◽

Vein Injury ◽

Good Exposure

ABSTRACT The surgical treatment of papillary thyroid carcinoma is the most frequent procedure in endocrine oncologic practice for endocrine surgeons. With the advent of positron emission tomography scan, many of these patients who had previous surgery in the form of total thyroidectomy with neck dissection present with recurrent nodal metastasis which is the cause of thyroglobulin increase. Reoperative surgery is fraught with increased incidence of complications mainly the internal jugular vein injury and nerve injuries. In this scenario, good exposure helps in avoiding these injuries, and also helps the surgeon. We describe the exposure of the posterior triangle by the division of sternocleidomastoid superiorly off the mastoid tip and retracting the muscle downward and suturing it back at the end of the procedure. How to cite this article Mayilvaganan S, Bothra S, Rashid M, Chekavar A, Vema AK, Agarwal A. Transection of Sternocleidomastoid for Selective Neck Dissection in Recurrent Papillary Thyroid Cancers. World J Endoc Surg 2017;9(1):32-34.

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The importance of flaps in reconstruction of locoregionally advanced lateral skull-base cancer defects: a tertiary otorhinolaryngology referral centre experience

Radiology and Oncology ◽

10.2478/raon-2021-0012 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Domen Vozel ◽

Peter Pukl ◽

Ales Groselj ◽

Aleksandar Anicin ◽

Primoz Strojan ◽

...

Keyword(s):

Skull Base ◽

Neck Dissection ◽

Temporal Bone ◽

Free Flap ◽

Radical Neck Dissection ◽

Selective Neck Dissection ◽

Flap Reconstruction ◽

Referral Centre ◽

Regional Flap ◽

Lateral Skull Base

Abstract Background The aim of the study was to identify the value of extensive resection and reconstruction with flaps in the treatment of locoregionally advanced lateral skull-base cancer. Patients and methods The retrospective case review of patients with lateral skull-base cancer treated surgically with curative intent between 2011 and 2019 at a tertiary otorhinolaryngology referral centre was made. Results Twelve patients with locoregionally advanced cancer were analysed. Lateral temporal bone resection was performed in nine (75.0%), partial parotidectomy in six (50.0%), total parotidectomy in one (8.3%), ipsilateral selective neck dissection in eight (66.7%) and ipsilateral modified radical neck dissection in one patient (8.3%). The defect was reconstructed with anterolateral thigh free flap, radial forearm free flap or pectoralis major myocutaneous flap in two patients (17.0%) each. Mean overall survival was 3.1 years (SD = 2.5) and cancer-free survival rate 100%. At the data collection cut-off, 83% of analysed patients and 100% of patients with flap reconstruction were alive. Conclusions Favourable local control in lateral skull-base cancer, which mainly involves temporal bone is achieved with an extensive locoregional resection followed by free or regional flap reconstruction. Universal cancer registry should be considered in centres treating this rare disease to alleviate analysis and multicentric research.

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