Comparison of the Retroauricular Approach and the Transcervical Approach for Excision of a Second Brachial Cleft Cyst

Publication date: Available online 15 December 2016
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Dongbin Ahn, Gil Joon Lee, Jin Ho Sohn
PurposeAlthough a retroauricular (RA) approach has been proposed for excision of a second brachial cleft cyst (BCC), there has been no direct comparison of the results of the RA approach with those of the conventional transcervical approach. We aimed to evaluate the surgical outcomes of the RA approach under direct vision and to demonstrate its benefits when compared with the conventional transcervical approach for excision of a second BCC.Patients and MethodsFrom January 2012 to May 2016, we enrolled 30 consecutive patients with a second BCC who underwent surgical excision as a primary treatment into this prospective case control study. Thirteen of the 30 patients underwent excision of a second BCC via the RA approach and 17, via the conventional transcervical approach. The surgical results, complications, and subjective scar satisfaction score were estimated and compared between the two groups.ResultsIn all 30 patients, excision of the second BCC was successfully completed under direct vision via RA or the conventional transcervical approach. The mean operating time was significantly less in the conventional group than that in the RA group (68.4 vs. 83.4 min, respectively; P = .019). There were no differences in total drainage amount, drainage duration, duration of hospital stay, or postoperative complications between the two groups. The mean scar satisfaction score was 6.2 in the conventional group and 8.8 in the RA group, and this difference was statistically significant (P < .001).ConclusionThe RA approach under direct vision for excision of a second BCC is feasible and has better cosmetic outcomes than the conventional transcervical approach with no increase in surgical morbidity.



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