Comparison of the incisions used in neck dissection for oral squamous cell carcinoma: a systematic review


  • Pavan Goud Pasham Department of General Surgery, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Tamil Nadu, India
  • Manoj Ananthappan Department of Plastic and Reconstructive Surgery, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Tamil Nadu, India
  • James S. Jesudasan Department of Oral and Maxillofacial Surgery, Sri Venkateswara Medcity, Tamil Nadu, India
  • Surya Rao Rao Venkata Mahipathy Department of Plastic and Reconstructive Surgery, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Tamil Nadu, India



Lymph node dissection, Oral squamous cell carcinoma, Incisions


Oral cancers are a significant disease group with more than 404,000 new cases worldwide in 2002. The most common cancer of the oral cavity is the squamous cell carcinoma; constituting 95%. The 5-year survival is around 50%. Surgery can be combined with any combination of radiotherapy, chemotherapy and immunotherapy. Spread of the tumour to the cervical nodes is an early and consistent event in the natural history. The extent of cervical involvement is reflected in the staging of the tumour and has prognostic implications. Surgical dissection of the cervical lymph nodes at risk of metastasis may be undertaken as part of the management of the primary tumour. This may be accomplished by classic radical neck dissections, supra ohmohyoid neck dissection, selective neck dissection etc.  The aim of the present review is to compare the clinical efficacy, the postoperative complications and the aesthetic outcome of the various incisions used in neck dissection for squamous cell carcinoma.  A total of six comparative studies and randomized control studies were included in this systematic review, out of a total of 175 articles yield following the search strategy, from PubMed and Mesh databases. The incisions were compared for access, healing and cosmetic outcome. Trifurcate incisions (‘Y’ incision) were found to have the maximum incidence of wound dehiscence. The apron incision has no reported wound dehiscence and has been described as a robust flap. As far as cosmetics and access as a whole is concerned the reversed hockey stick incision is superior.


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Systematic Reviews