Subcutaneous Endoscopic Surgery In The Head And Neck Region – Single Port, Non Insufflatory Approach

Abstract

INTRODUCTION:  Patients undergoing plastic surgery in the Head and Neck region for subcutaneous lumps, blood vessel dilatation or muscle reduction request a scar free procedure. Cavitary endoscopy for examination and surgery has been popular since the late 1980s. Subsurface endoscopy is not as common except for facial aesthetic procedures. The authors describe a single port approach without the need for carbon dioxide insufflation.

AIM: To demonstrate the efficacy and safety of subsurface endoscopic procedures in the head and neck region.

METHODS: 29 patients with head and neck swellings or deformity were treated by the sub surface endoscopic, single port approach without insufflation of carbon dioxide from Aug 2019 till date.

Incisions were placed within the hairline or were placed in concealed locations.

A 30-degree viewing 4mm endoscope (Karl Storz) along with its cold light source and 3-chip camera with a fenestrated guard was used along with suitable retractors and other instruments.

Conversion to open surgery if required, operating time, postoperative pain, complications if any and patient satisfaction rates on a VAS scale from 1- 10 were noted.

RESULTS: All 29 patients underwent subsurface endoscopic surgery successfully, with high patient satisfaction rates. Postoperative pain was less than 4/10 with minimal analgesic needs. There was minimal bleeding at the operative site. Only one patient had transient palsy of the frontal branch of facial nerve which recovered completely.

CONCLUSION: Subsurface endoscopic surgery in the head and neck region is safe, with excellent results.

CLINICAL SIGNIFICANCE: The option of subsurface endoscopic surgery outweighs open surgery in the head and neck region by avoiding visible unsightly scars.