Functional and cosmetic outcomes of robot-assisted neck dissection by a postauricular facelift approach for head and neck cancer

Abstract

Objectives: The purpose of this study was to compare the functional and cosmetic outcomes of robotassisted neck dissection with those of conventional neck dissection. Materials and methods: We prospectively analyzed 113 patients with head and neck cancer who underwent unilateral neck dissection by a robot-assisted postauricular facelift approach (38 patients) or conventional trans-cervical approach (75 patients). Postoperative functional outcomes such as edema, sensory loss, pain, and fibrosis in the neck, and limitations of neck and shoulder motion, and cosmetic satisfaction scored by questionnaire were evaluated serially up to 1 year postoperatively, and compared between the two groups. Results: There were differences at baseline clinicopathologic characteristics including age, T classification and stage between the two groups. The mean score of neck edema was lower in the robotic group than that of the conventional group at 1 day and 3 days postoperatively, and sensory loss was also lower in the robotic group at 1 day, 3 days and 1 week postoperatively (P < 0.05). The postoperative cosmetic satisfaction were significantly higher in the robotic group than the conventional group at 1 month, 3, 6, and 12 months postoperatively. Transient marginal nerve palsy was higher in the robotic group than the conventional group (P = 0.043). Conclusion: Postoperative neck edema and sensory loss were lower in the robotic group in the early postoperative period although its clinical significance is not clear. Cosmetic satisfaction was superior in the robotic group.