ICHNO-ECHNO 2022 - Abstract Book

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ICHNO-ECHNO 2022

neck melanomas and lymphatic levels of the neck involved in metastasis. The aim was to determine which neck levels it may be possible to spare in neck dissection to improve patient morbidity without the risk leaving microscopic disease in situ and thus possible nodal recurrences. Materials and Methods A retrospective analysis of 126 consecutive head and neck melanomas treated at one UK tertiary centre between 2004- 2021. Patients grouped by primary anatomical location and sentinel node neck levels identified. Results 126 patients, average age 66.3 years, equal gender distribution presented with a primary melanoma of head or neck. 109 patients had identifiable nodes. 66 primaries located on anterior head, 19 laterally, 7 posteriorly and 17 on the neck. An average of 1.88 nodes excised per patient (range 1-5). No patients with a posterior primary drained to level I. In anterior primaries Level I, II and III were most commonly involved and IV and V least commonly. Lateral primaries involved drainage to nodes outside of routine neck dissection levels, drainage to multiple levels and non-adjacent levels. Neck primaries had a variable drainage pattern (Table 1).

Conclusion Our data corroborates previous studies demonstrating head and neck cutaneous lymphatic drainage can be unpredictable. However, we observed no spread to level I from posterior primaries, suggesting it could be safe to spare this level in SND in this specific cohort of patients. Infrequent drainage to levels IV and V was observed in anterior primaries which may inform decisions when considering risks and benefits for SND versus CND for individual patients. Furthermore, we emphasise the importance of considering drainage to multiple nodal levels when planning neck dissection, in particular for patients with non-adjacent levels.

PO-0102 Factors for the Prediction of Anterolateral Thigh Free Flap Thickness

R. Mohammad 1 , J. Huh 1 , W. Cha 1 , J. Ji 2 , W. JEONG 3

1 Seoul National University Bundang Hospital, Otolaryngology - Head & Neck surgery, seongnam-si, Korea DPR; 2 Seoul National University Bundang Hospital, Otolaryngology - Head & Neck surgery, seonganm-si, Korea DPR; 3 Seoul national University Bundang Hospital, Otolaryngology - Head & Neck surgery, seongnam-si, Korea DPR Purpose or Objective Objective: The versatility of anterolateral thigh flap (ALT) has made it one of the workhorse flaps in microvascular head and neck reconstructive surgeries. Nevertheless, its application in head and neck reconstruction is limited due to its thickness. We aimed to assess the factors that influence and predict ALT flap thickness prior to surgery. Materials and Methods Methods: A retrospective analysis was conducted from 2004 to 2021 for patients who underwent lower extremity computed tomographic angiography (CTA). 216 flap/skin thickness of the anterolateral thigh region was evaluated. Statistical analysis was performed for factors affecting the thickness of the flap. Results Results: The mean (SD) and range of thickness of ALT were 7.24mm (4.04) and 1.22-25.77, respectively. Gender (male, 0R=5.48), age (>50, OR=3.38), and BMI (>23, OR=2.06) were factors affecting flap thickness.