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September 1995

Transclavicular Approach to the Neck, Thoracic Inlet, and Axilla

Author Affiliations

From the Department of Otolaryngology (Drs Papsin and Freeman) and the Division of Orthopedic Surgery (Dr Bell and Ms Davis), Mount Sinai Hospital, University of Toronto, Ontario.

Arch Otolaryngol Head Neck Surg. 1995;121(9):984-987. doi:10.1001/archotol.1995.01890090028005

Objective:  To describe claviculotomy and claviculectomy for access to lesions of the lower part of the neck, with simultaneous reconstruction.

Methods and Materials:  A retrospective review of 15 patients who underwent claviculotomy for access to the lower part of the neck.

Results:  Eight patients underwent plate reconstruction, and one patient required subsequent removal. Three patients underwent total claviculectomy, and four patients underwent partial claviculectomy. Ten patients are alive and free of disease, three have died of disease, and two are alive with disease. All but two patients are satisfied with shoulder function, and one patient is dissatisfied with the cosmetic result.

Conclusions:  The claviculotomy and claviculectomy technique for tumors that transgress the neck, thoracic inlet, and axilla offers maximal exposure for excision, vascular control, and preservation of vital structures. Modern plating techniques have allowed clavicular reconstruction with improved cosmesis and preservation of shoulder stability.(Arch Otolaryngol Head Neck Surg. 1995;121:984-987)

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