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. 2021 Oct;41(5):419-431.
doi: 10.14639/0392-100X-N1293.

VITOM-3D-assisted retroauricular neck surgery (RANS-3D): preliminary experience at Candiolo Cancer Institute

Erika Crosetti  1 , Giulia Arrigoni  1 , Alessandra Caracciolo  1 , Martina Tascone  1 , Andrea Manca  1 , Giovanni Succo  1   2
Affiliations

VITOM-3D-assisted retroauricular neck surgery (RANS-3D): preliminary experience at Candiolo Cancer Institute

Erika Crosetti et al. Acta Otorhinolaryngol Ital. 2021 Oct.

Abstract
in English, Italian

Objective: The recent introduction of 3D exoscopic surgery has engendered interesting technical improvements in head and neck surgery. The main goal of this study was to describe the application of 3D exoscopic technology on a wide range of pathologies of the neck, benign and malignant, through a minimally invasive retroauricular approach.

Methods: In the period January-December, 2019, 40 consecutive patients underwent neck surgery with a retroauricular approach, enhanced by using a 3D exoscope at the Head and Neck Oncological Unit of Candiolo Cancer Institute.

Results: Data regarding time to drain removal, length of hospitalisation, degree of pain experienced, need for opioid drugs during hospitalisation and after discharge, and intra-operative and post-operative complications were collected. All patients were followed for a minimum of 90 days with possible complications evaluated at each post-operative visit. Post-operative outcomes were evaluated at 3 months after surgery.

Conclusions: The current study indicates that VITOM-3D-assisted retroauricular neck surgery (RANS-3D) may be an interesting approach for neck surgery. The hybrid execution of neck dissection under direct and exoscopic vision represents a valid alternative to video-assisted endoscopic- and robot-assisted techniques.

Chirurgia cervicale VITOM-3D assistita con accesso retroauricolare (RANS-3D): l’esperienza preliminare dell’Istituto di Candiolo.

Oggetto: Il recente avvento della chirurgia esoscopica 3D ha consentito, nell’ambito della chirurgia cervico-cefalica, l’introduzione di interessanti innovazioni tecnologiche. L’obiettivo del seguente studio è stato quello di descrivere l’impiego della tecnologia esoscopica 3D su un’ampia gamma di patologie cervico-cefaliche, benigne e maligne, trattate con accesso mini-invasivo retroauricolare.

Metodi: Nel periodo Gennaio-Dicembre 2019 presso la Divisione di Chirurgia Oncologica Cervico-Cefalica dell’Istituto IRCCS-FPO di Candiolo 40 pazienti consecutivi sono stati sottoposti a chirurgia cervicale con incisione retroauricolare con ausilio dell’esoscopio 3D.

Risultati: Sono stati raccolti i dati relativi alla durata di mantenimento del drenaggio, durata della degenza ospedaliera, entità del dolore lamentato dal paziente (scala VAS), necessità di somministrazione di oppioidi durante la degenza e dopo la dimissione, complicanze intra- e postoperatorie. Tutti i pazienti sono stati seguiti per un periodo minimo di 90 giorni, valutando, ad ogni visita post-operatoria, la comparsa di possibili complicanze. I risultati post-operatori sono stati valutati a distanza di 3 mesi dall’intervento chirurgico.

Conclusioni: Il seguente studio conferma che il RANS-3D rappresenta un interessante approccio chirurgico al collo. L’esecuzione ibrida della dissezione laterocervicale, sotto visione diretta ed esoscopica, rappresenta una valida alternativa alle tecniche endoscopiche e robot-assistite.

Keywords: 3D; RANS; exoscopic surgery; neck dissection.

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Conflict of interest statement

Conflict of interest

The Authors declare no conflict of interest.

Figures

Figure 1.
Figure 1.
Typical operating room setting for VITOM-3D assisted neck dissection.
Figure 2.
Figure 2.
(A) Retroauricular skin incision. (B) Elevation of skin flap along a subplatysmal plane and placement of self-retaining retractor.
Figure 3.
Figure 3.
Cosmetic results in a patient treated for benign pathology (branchial cyst).
Figure 4.
Figure 4.
Cosmetic results in a patient treated for head neck malignant pathology (oropharyngeal squamous cell carcinoma).
Figure 5.
Figure 5.
(A) Retroauricular facelift skin incision and cervical median skin window. (B) Cosmetic results in a patient treated for thyroid malignant pathology.
See this image and copyright information in PMC

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