Stealth surgery: transaxillary subcutaneous endoscopic excision of benign neck lesions

Background: Benign neck lesions are traditionally removed through an overlying incision. The resultant scar call be aesthetically displeasing. We previously reported our experience with a transaxillary subcutaneous endoscopic approach for management of torticollis. We now report a similar technique from removal of benign lesions of the neck. Methods: The study Uses a retrospective review of 5 elective transaxillary endoscopic procedures from March to December 2006. The lesions included all enlarged cervical lymph node, thyroglossal duct cyst, dermoid cyst, ectopic dilated neck vein, and a parathyroid adenoma. Outcome measures included need for conversion, cosmetic outcome, and complications. Results: All procedures were successfully completed using the endoscopic approach. Postoperative pain was controlled with acetaminophen, and all patients were discharged from the hospital the same day. There were no intraoperative complications. The patient who had a thyroglossal cyst removed developed a postoperative scroma that resolved spontaneously. All families were pleased with the cosmetic results. Conclusions: A transaxillary subcutaneous endoscopic approach call be applied effectively to a variety of benign lesions of the neck. allowing adequate exposure for dissection, and resulting in a quick recovery. Neck scarring, is absent, with small scars, well hidden in the axilla. (C) 2008 Elsevier Inc. All rights reserved.