COMPARISON OF SCHOBINGER INCISION AND MACFEE INCISION IN NECK DISSECTION-A PROSPECTIVE STUDY

Abstract

Objectives: There are many incisions that are most commonly recommended for performing neck dissection for oral cancer. The need towards more conservative surgical treatment of oral cancer has led to performing various incisions.

Methods: In this study the Schobinger and MacFee Incisions were used in radical neck dissection (RND) and compared intraoperatively, postoperative and during follow up at regular intervals. The study was conducted from November 2011 to June 2014 on 30 patients who were biopsy proven case of squamous cell carcinoma (SCC). Fifteen patients aged 20-60 including males and females were randomly sorted into Schobinger incision group and MacFee incision group. The study was conducted in the Department of Oral and Maxillofacial Surgery SDM College of Dental Sciences and Hospital, Dharwad, Karnataka, India.

Result: The Schobinger incision (Group I) and MacFee incision (Group II) both had 12 males and 3 females. Time taken to raise and close the flap was greater among Schobinger incision patients. Dehiscence was observed less in the MacFee incision group. Marginal necrosis of the flap was also less in MacFee incision. Wound contraction, infection, and scar assessment was better in the MacFee incision compared to the Schobinger incision.

Conclusion: MacFee incision was observed to have better cosmetic effect, the time taken for the raise and closure of the flap was less, and post-operative healing was better achieved. The Schobinger incision on the other hand provided a better exposure of neck during dissection, but a higher incidence of marginal necrosis and contracture of the flap with scaring was observed. In MacFee incision there was difficulty observed during neck dissection under the flap and in the posterior triangle.

Keys words: Schobinger Incision, MacFee Incision, Neck Dissection, Healing, Scar assessment.