Endoscopically-Associated Hairline Approach to Excision of Second Branchial Cleft Cysts

To improve the treatment outcome and post-operation rehabilitation of patients with second branchial cleft cysts (SBCC), 46 patients were operated for SBCC. 22 patients were operated by conventional approach, 22 patients were operated by original occipital hairline approach and 2 patients were operated via axillary approach. Assessment of intra-operation and post-operation complications was done and comparative evaluation of the preparations of the morphological structure in the main and reference group I was conducted. Clinical psychological assessment was performed in the post-operation period. Based on the clinical criteria and morphological method, the authors made conclusions on the benefits of the proposed approach to the excision of SBCC and determined indications and contraindications to endoscopically-associated surgery via the proposed approach. Comparative analysis of beneficial outcome clinically significant criteria of the conventional, axillary and proposed original approaches showed differences in the following criteria: “average operation time”, “average wound dressing duration”, “average duration of hospitalization” and “subjective satisfaction with incision scar”. There were no differences revealed in the criteria “average incision length”. The proposed approach allowed the authors to shorten the treatment duration and to accelerate the patients port-operation recovery. Due to the proposed approach, the incision opened the fascial layer where the cyst was located. The dissection was performed along the hairline and did not involve upper and lower located layers. Minimal surgery traumatic rate of the proposed approach was proved by the morphological studies.