Evaluation of Outcomes of Single Extended Cervical Incision for Neck Dissection in Oral Cancer Patients at Tertiary Care Army Hospital in India-a Case Series

Abstract Background The neck dissection has gone through various modifications since its inception and is approached through many varieties of incision and their modifications.This study aims to evaluate the effectiveness of modified apron incision both in terms of oncological clearence and cosmetic outcome in patients of head and neck cancer in a tertiary care army hospital. Method This Prospective Observational study was conducted in the Department of Surgical Oncology, R & R Hospital, New Delhi from February 2023 to December 2024. 50 patients were evaluated for the perioperative assessment of accessibility of Level I-V lymph nodes using Likert scale, lymph node yield based on HPE report, evaluation of morbidity in terms of wound infection using ASEPSIS SCORE, presence or absence of Seroma and Flap dehiscence or necrosis using a set devised proforma and scar contracture and cosmesis by using Scar Cosmesis Assessment and Rating score (SCAR). Results The mean age (years) of the patients was 58.3 ± 11.2 (Range: 34–83). The most common site of lesion in our study were the left and right buccal mucosa, along with the left lower alveolus, each contributing 20% of the cases. The majority of patients (64%) are in the more advanced stages (T3/T4), while a smaller proportion (36%) are in the earlier stages (T1/T2). MRND III was the most frequently performed type of neck dissection, with 62% of patients undergoing this procedure, followed by MRND II (36%) and MRND I (2%). The mean lymph node yield was 30.7 with a standard deviation (SD) of 10.8. There were no reported cases of flap necrosis in this patient sample. Out of 50 patients, the majority (88%) did not develop seroma, while 12% did. The incidence of flap dehiscence is very low, with only 2% of the patients affected. Conclusion In Conclusion, our study demonstrated that use of modified apron incision for comprehensive neck dissection in patients of Head and neck cancer has a good oncological lymph node yield and a better cosmesis in postoperative period.