Retroauricular hairline incision for removal of upper neck masses

Background/Objectives. The general population has been increasingly concerned about cosmesis and hopeless about prominent or invisible postoperative scars of the face and neck. The purpose of this study was to evaluate the benefit of a retroauricular hairline incision (RAHI) by comparing it with conventional cervical incision for removal of upper neck masses. Study Design. Prospective clinical study. Methods: Thirty-four patients with upper neck masses were divided into two surgical groups of RAHI (17) and conventional cervical incision (17) matched by age, sex, marital status and size, location, pathology of lesions. The operation time, complications, length of hospital stay, and subjective satisfaction with incision scar checked by visual analogue scale were compared between groups. Results: The lesions of each group were congenital cysts (6), abscesses (2), inflammatory masses (2), and benign (6) or malignant (1) tumors and located in the upper neck. Mean operation time was 51 +/- 17 minute in the RAHI group and 41 +/- 13 minutes in the controls (P = .064). Mean hospital stay and complication rates were comparable between groups. Mean score of patient's satisfaction was 8.9 +/- 0.7 in the RAHI group and 4.5 +/- 2.7 in the controls (P < .001). The degree of incision scarring did not differ between groups, but the scars were less visible in the RAHI group because of hiding by the auricle and hair. Conclusions: The postauricular approach leading to a potentially invisible area of operation has a clear cosmetic benefit compared with conventional cervical incision. This will be helpful for patients with surgically indicated upper neck masses who hope for invisible incision scars.