Direct Solution-Phase Synthesis and Functionalization of 2D WSe2 for Ambient Stability.

2H phase tungsten diselenide (WSe2 ) is a p-type 2D semiconductor from the transition metal dichalcogenides (TMDs) family with unique optoelectrical properties. Solution phase production of atomically thin WSe2 is challenging due to its instability under ambient conditions. We present a highly efficient and scalable solution method for simultaneously exfoliating and functionalizing WSe2 by leveraging the non-covalent interaction between mercapto-group and bulk WSe2 . Single and few-layer 2H phase pure WSe2 sheets of lateral size up to 5 µm with minimal basal plane defects, as revealed by XPS, Raman and FTIR spectroscopy, are produced in a water-ethanol mixture. Remarkably, WSe2 dispersion remains stable even at high concentrations (10 mg/mL) and exhibited high colloidal stability with a shelf-life exceeding a year. The findings from our study suggest that through precise manipulation of intercalation chemistry, mass production of solution-processable phase-sensitive 2D materials such as WSe2 can be achieved. This advancement holds great potential for facilitating their practical utilization in various real-world applications.

Expression of matrix metalloproteinase-12 is correlated with extracapsular spread of tumor from nodes with metastasis in head and neck squamous cell carcinoma.

Matrix metalloproteinases (MMPs) play an important role in tumor invasiveness and metastasis. The aim of this study was to investigate the expression pattern of MMPs in the primary tumor of head and neck squamous cell carcinomas (HNSCC) with cervical node metastasis and to correlate the expression of MMP in the primary tumor with the presence of extracapsular spread (ECS) in nodes with metastasis. A retrospective study was conducted. Paraffin blocks were obtained from 40 HNSCC patients with cervical node metastasis who underwent surgery as an initial treatment between 2004 and 2011. Expressions of MMP-2, MMP-3, MMP-12, and MMP-14 were investigated immunohistochemically. MMP-2, MMP-3, MMP-12, and MMP-14 were expressed in 27, 47.5, 55, and 57.5 % of cases, respectively. MMP-12 expression was found to be significantly associated with ECS and correlated with nodal metastasis (p = 0.024, 0.011). No relation was found between MMP expression and survival. MMP-12 expressed in the primary tumor is a molecular marker that may be useful for predicting ECS in HNSCC patients with metastatic nodal disease.

Pattern of expression of cyclooxygenase-2 in malignant transformation of sinonasal inverted papilloma.

OBJECTIVE: Cyclooxygenases (COXs) are enzymes that catalyze the conversion of arachidonic acid to prostaglandins. Many studies have suggested that COX-2, the inducible form of COX, is important in carcinogenesis. However, little is known about the pattern of expression of COX-2 in a multistep process of malignant transformation of sinonasal inverted papilloma (IP). In this study, we investigated COX-2 expression in IPs, IPs with dysplasia, IPs with squamous cell carcinoma (SCC), and primary SCCs of sinonasal tract. STUDY DESIGN: A retrospective study was conducted. SETTING: The setting was a tertiary care referral center. SUBJECTS AND METHODS: The expression of COX-2 was evaluated by immunohistochemistry in 56, 7, 18, and 17 cases of IPs, IPs with dysplasia, IPs with SCC, and primary SCCs, respectively. Furthermore, we investigated the possible correlation between the expression of COX-2 and clinicopathologic variables in patients with IPs with SCC and primary SCC patients. RESULTS: Positive immunoreactivity for COX-2 was observed in 3 (5.4%) of 56 IPs, 7 (38.9%) of 18 IPs with SCC, and 7 (41.2%) of 17 primary SCCs, whereas it was not observed in IPs with dysplasia. The percentage of tumors with COX-2-positive immunostaining was significantly higher in IPs with SCC and primary SCCs compared with benign IPs. There was no significant correlation between the expression of COX-2 and clinicopathologic variables, such as tumor stage, histologic differentiation, and the proportion of malignant areas in patients with IPs with SCC. CONCLUSION: Cyclooxygenase-2 may play an important role in the process of malignant transformation from IP to SCC.

The clinicopathologic differences in papillary thyroid carcinoma with or without co-existing chronic lymphocytic thyroiditis.

The goal of this study is to determine the clinicopathologic differences in patients with papillary thyroid carcinoma (PTC) with or without chronic lymphocytic thyroiditis (CLT). We reviewed the medical records of 195 consecutive PTC patients who underwent total thyroidectomy and bilateral central lymph node dissection from April 2008 to March 2010. The differences in clinicopathologic factors, such as age, gender, size of primary tumor, perithyroidal invasion, lymphovascular invasion, capsular invasion, and central lymph node (CLN) metastasis, were analyzed in PTC patients with or without CLT. Among 195 patients, 56 (28.7%) had co-existing CLT. Patients with CLT had the following characteristics as compared to patients without CLT: significantly younger, female predominance, smaller tumor size, and lower incidence of capsular invasion (p = 0.038, 0.006, 0.037, and 0.026, respectively). Also, patients with CLT (12.5%) had a significantly lower incidence of CLN metastases than patients without CLT (28.1%; p = 0.025) based on univariate analysis. Moreover, multivariate analysis showed that younger age (p = 0.042, odds ratio = 1.033) and female gender (p = 0.012, odds ratio = 6.865) are independent clinical factors in patients with CLT compared to patients without CLT. CLT was shown to be commonly associated with PTC. Compared to patients with PTC without CLT, patients with CLT were younger with a female predominance, which are the most important and well-known prognostic variables for thyroid cancer mortality.

Clinical and histologic features of inverted papilloma-associated malignancy.

The objectives of the study were to analyze the clinical features of inverted papillomas (IP) associated with malignancy and to evaluate the correlation of tumor stage, survival and histolologic features. We conducted a retrospective review of 18 IP associated with malignancy patients. In addition, we compared histopathologic characteristics (tumor differentiation and malignant cell proportion) with clinical outcomes. Eleven of the tumors were present on the nasal cavity and 7 on the maxillary sinus. The rates of synchronous and metachronous malignancy were 10.1 and 1.1%, respectively. The disease-free survival rate was 83.3%. The tumors were staged as T1 (5/18), T2 (2/18), T3 (8/18), and T4 (3/18). According to the percentage of the malignant cell in the entire tumor tissue, 4 patients (22%) were in grade I, 4 patients (22%) were in grade II, 3 patients (17%) were in grade III, and 7 patients (39%) were in grade IV. There was no relationship between recurrence- and/or disease-free survival and histologic findings including tumor differentiation and malignant proportion. IP-associated malignancy tends to occur synchronously and have more favorable prognosis compared to other sinonasal malignancy. Furthermore, the proportion of malignant cell to IP and tumor stage seems not to affect the clinical outcome of IP-associated malignancy.

Characteristics of primary papillary thyroid carcinoma with false-negative findings on initial (18)F-FDG PET/CT.

BACKGROUND: We often observe that uptake of tracer is not detected in the primary cancer focus in patients with histologically proven papillary thyroid carcinoma (PTC) on preoperative (18)F-fluorodeoxyglucose positron emission tomography-computed tomography ((18)F-FDG PET/CT). Therefore, we analyzed the clinical and pathologic variables affecting false-negative findings in primary tumors on preoperative (18)F-FDG PET/CT. METHODS: We retrospectively reviewed the medical records of 115 consecutive patients who underwent (18)F-FDG PET/CT for initial evaluation and were diagnosed with PTC by postoperative permanent biopsy. The clinical and pathologic characteristics that influence the (18)F-FDG PET/CT findings in these patients were analyzed with respect to the following variables: age, gender, tumor size, multifocality of the primary tumor, perithyroidal invasion, lymphovascular or capsular invasion, and central lymph node metastasis-based final pathology. RESULTS: Twenty-six (22.6%) patients had false-negative (18)F-FDG PET/CT findings. In patients with negative (18)F-FDG PET/CT findings, tumor size, and perithyroidal and lymphovascular invasion were significantly less than in patients with positive (18)F-FDG PET/CT findings. Tumors >1 cm in size were correlated with (18)F-FDG PET/CT positivity. On multivariate analysis, perithyroidal invasion (P = 0.026, odds ratio = 7.714) and lymphovascular invasion (P = 0.036, odds ratio = 3.500) were independent factors for (18)F-FDG PET/CT positivity. However, there were no significant differences between (18)F-FDG PET/CT positivity and age, gender, capsular invasion, and central lymph node metastasis based on final pathology. CONCLUSIONS: Tumor size and perithyroidal and lymphovascular invasion of papillary carcinoma can influence (18)F-FDG PET/CT findings. Absence of perithyroidal and lymphovascular invasion were independent variables for false-negative findings on initial (18)F-FDG PET/CT in patients with PTC.

Is there any synergic effect for coadministration of mitomycin C and halofuginone on the skin wound healing?

OBJECTIVE: This study compared the potencies of the antifibrotic agents mitomycin C (MMC) and halofuginone (HFN) and investigated whether coadministration of these agents produces synergic effects in an animal skin wound model. SUBJECTS AND METHODS: Twenty male Sprague-Dawley rats were used for this study. After a full-thickness excisional wound was made on the dorsum of each rat, each rat was treated with topical mitomycin, intraperitoneal HFN, or both. Wound surface areas were measured over time, and histologic analysis was performed after wounds healed completely. RESULTS: The groups treated with MMC alone, HFN alone, and a combination of the two all exhibited delayed wound healing compared with the untreated group. Histologically, fibrosis and matrix metalloproteinase-2 expression were significantly inhibited in the treated groups. However, there were no gross or histologic differences between the MMC-treated group, the HFN-treated group, and the combination-treatment group. CONCLUSIONS: Both MMC and HFN inhibited excessive fibrosis. However, there was no significant difference in the antifibrotic effects of MMC and HFN on surgically induced skin wounds. Moreover, combination treatment with both MMC and HFN failed to confer an additional antifibrotic effect on skin wounds when compared with treatment with MMC or HFN alone.

Occult contralateral carcinoma in patients with unilateral papillary thyroid microcarcinoma.

BACKGROUND: The optimal resection extent for papillary thyroid microcarcinoma (PTMC) confined within a unilateral lobe remains controversial. MATERIALS AND METHODS: We reviewed the medical records of 132 consecutive patients who underwent total thyroidectomy for the treatment of clinically unilateral PTMC between March 2005 and March 2009. The frequency, pattern, and predictive factors for occult contralateral carcinoma in these patients were analyzed with respect to the following variables: age, gender, tumor size, multifocality of primary tumor, presence of perithyroidal invasion, lymphovascular invasion or capsular invasion, presence of central lymph node metastasis, and the presence of coexistent benign nodules in the contralateral lobe based on preoperative evaluation and final pathology. RESULTS: A total of 22 patients (16.7%) had occult PTMC in the contralateral lobe. In multivariate analysis, multifocality of the primary tumor (P = 0.026, odds ratio = 7.714) and the presence of coexistent benign nodule in the contralateral lobe by preoperative evaluation (P = 0.036, odds ratio = 3.500) were independent predictive factors for occult contralateral PTMC presence. However, there were no significant differences between the presence of occult contralateral carcinomas and age, gender, tumor size, perithyroidal invasion, lymphovascular invasion, capsular invasion, central lymph node metastasis, and coexistent benign nodules by final pathology. CONCLUSIONS: Based on our findings, total thyroidectomy, including the contralateral lobe, should be considered for the treatment of unilateral PTMC if it presents as a multifocal tumor in the unilateral lobe and/or if nodules are found in the contralateral lobe during preoperative evaluation.

The preventive effect of mitomycin-C on the external auditory canal fibrosis in an experimentally induced animal model.

OBJECTIVE: The aim of this study was to investigate the preventive effect of mitomycin-C (MMC) on external auditory canal (EAC) fibrosis in an animal model. STUDY DESIGN: This is a randomized, controlled animal study. SUBJECTS AND METHODS: Sixteen guinea pigs were used for this study. After the skin of cartilaginous EAC was injured with an electrocautery, the cottonoid soaked in MMC solution with concentration of 0.4 mg/mL was topically applied for 5 minutes to the injured EAC in an MMC-treated group (n = 8). In addition, saline was applied in the control group (n = 8). At 4 weeks after injury, postsurgical changes of EAC were evaluated by histologic examination. RESULTS: External auditory canal fibrosis was induced by injury with electrocautery. The MMC-treated group showed less degree of fibrosis without differences in epithelialization and inflammatory cell infiltration. CONCLUSION: This study suggests that MMC can be helpful in preventing EAC fibrosis after injury.

Predictive factors for ipsilateral or contralateral central lymph node metastasis in unilateral papillary thyroid carcinoma.

OBJECTIVES: To investigate the incidence and the risk factors for occult ipsilateral or contralateral central neck lymph node (LN)metastasis in patients with unilateral papillary thyroid carcinoma (PTC) and a clinically negative neck. SUMMARY BACKGROUND DATA: Elective central lymph node dissection (CLND) in patients with PTC remains controversial. There have been few prospective studies assessing accurate histopathologic information and predictive factors for the presence of metastasis to the ipsilateral or contralateral central compartment of the neck in patients with PTC and clinically negative neck nodes. METHODS: We reviewed a prospective protocol of 111 unilateral PTC patients with clinically node-negative necks who have received total thyroidectomy and elective bilateral CLND from 2005 to 2007. The relationships between LN metastasis to the ipsilateral or contralateral central neck compartment and clinico-pathologic factors such as age, sex, size of primary tumor, perithyroidal invasion, lymphovascular invasion, and capsular invasion were analyzed. RESULTS: Occult central neck LN metastasis was present in 54.1% (60/111). Of these patients, bilateral central LN metastases were present in 50% (30/60), unilateral ipsilateral central LN metastasis in 43.3% (26/60), and unilateral contralateral central LN metastasis in 6.7% (4/60). In the univariate analysis, the rate of ipsilateral central LN metastasis was significantly higher in male patients, high risk MACIS score, carcinoma with a maximal diameter of greater than 1 cm, and carcinoma with lymphovascular invasion (P < 0.05). The rate of contralateral central LN metastasis was significantly higher in cases of carcinoma with a maximal diameter of greater than 1 cm, lymphovascular invasion or histologically proven metastasis to the ipsilateral central LN (P < 0.05). Multivariate analysis showed that the tumor size was an independent risk factor for the presence of ipsilateral central LN metastasis, and the presence of ipsilateral central LN metastasis was the only independent predictor for the presence of contralateral central LN metastasis. CONCLUSIONS: Unilateral PTC with a maximal diameter of greater than 1 cm is associated with a high rate of ipsilateral central neck LN metastasis. Moreover, ipsilateral central LN metastasis is a potential independent predictor of synchronous contralateral central LN metastasis. These findings suggest that contralateral as well as ipsilateral elective CLND, performed during the initial thyroid operation, may be effective in the management of patients with unilateral PTC having a maximal diameter of greater than 1 cm and ipsilateral central LN metastasis.

Predictive factors of level IIb lymph node metastasis in patients with papillary thyroid carcinoma.

BACKGROUND: The extent of neck dissection (ND) appropriate for necks yielding clinical evidence of metastases of papillary thyroid carcinoma (PTC) is controversial. The need for level IIb lymph node (LN) dissection is particularly uncertain in view of its association with postoperative shoulder dysfunction. In the present study, we examined the frequency, pattern, and predictive factors of level IIb LN metastases in PTC patients with clinically positive lateral neck nodes. METHODS: We reviewed the medical records of 76 PTC patients who underwent therapeutic lateral ND for the treatment of clinically positive lateral neck nodes between March 2005 and July 2008. ND specimens were separately obtained for analyzing LN involvement with respect to neck level. RESULTS: Metastatic disease at levels II, III, IV, and V, was seen in 40 (52.6%), 55 (72.4%), 52 (68.4%), and 12 (15.8%) of the patients, respectively. The metastasis rate in level IIb was 11.8% (9 of 76). By univariate analysis, the rate of level IIb LN metastasis was significantly higher in patients with positive level IIa LNs and positive LNs in all lateral neck levels (levels IIa + III + IV) (P < .05). Multivariate analysis showed that positive LN involvement in all lateral neck levels (IIa + III + IV) was an independent predictive factor of level IIb LN metastasis (P = .044, odds ratio = 9.692). CONCLUSIONS: Level IIb LN dissection may be omitted in the treatment of positive neck nodes in PTC patients if multilevel involvement including level IIa involvement is absent.

Sialectasis of Stensen's duct: an unusual case of recurrent cheek swelling.

Sialectasis of Stensen's duct is an uncommon condition of the salivary gland featuring dilation of the parotid duct. Various surgical and non-surgical treatment modalities have been reported as treatment for Stensen's duct stenosis. In this report, a rare case of sialectasis with fusiform dilatation of the parotid duct is presented, which was corrected by a simple and easy surgical technique creating a new opening in the buccal mucosa.

Chyle leakage in patients undergoing thyroidectomy plus central neck dissection for differentiated papillary thyroid carcinoma.

BACKGROUND: Chyle leakage is an uncommon complication of lateral neck dissection for metastatic papillary thyroid carcinoma (PTC). There have been no reports on chyle leakage after central neck dissection not combined with lateral neck dissection. We therefore investigated chyle leakage in PTC patients undergoing thyroidectomy and central neck dissection. METHODS: A total of 283 new patients with differentiated PTC underwent total thyroidectomy plus central neck dissection. The amount and duration of drain leakage, and the concentrations of triglycerides and cholesterol in drain fluid and serum were measured in patients who had suspected postoperative chyle leakage. The incidence and management of chyle leakage were analyzed. RESULTS: Intraoperative chyle leakage was not found in any patient, although postoperative leakage was detected in four patients (1.4%). Mean +/- standard deviation peak 24-hour drainage was 122 +/- 57 mL, and duration of leakage was 10 +/- 7 days. Mean triglyceride concentration of drainage fluid was 433 +/- 182 mg/dL. These patients were treated with pressure dressings and a medium-chain triglyceride diet. One patient underwent intralesional injection of OK-432 for localized chyle accumulation. All chyle leakages stopped after conservative management without surgical intervention. CONCLUSION: Chyle leakage can occur after thyroidectomy and central neck dissection not combined with lateral neck dissection. These findings will aid in the recognition and treatment of this uncommon complication during the early postoperative period.

Clinical characteristics of external auditory canal cholesteatoma in children.

OBJECTIVE: The purpose of this study was to investigate the characteristics of pediatric external auditory canal cholesteatoma (EACC). METHODS: Chart review of nine children with EACC between January 1, 2000 and December 31, 2007 was performed with subsequent analysis of etiologic factors, associated symptoms, otoscopic findings, imaging features, and treatment outcomes. RESULTS: The average age of patients was 10.3 years (range 6-15 years). Five patients were girls and four were boys. There was greater incidence of EACC on the right side (eight of nine patients). Otorrhea and hearing impairment were the most common presenting symptoms. The inferior wall of the external auditory canal was most commonly involved. Five patients underwent cholesteatoma removal under general anesthesia. Surgical procedures were performed in four patients. No recurrence except in one patient was found during the follow-up period. CONCLUSIONS: Pediatric EACC is reported as a rare condition, but its low occurrence may be due to underreporting. Early diagnosis and treatment is essential in the management of pediatric EACC.

The preventive effect of halofuginone on posterior glottic stenosis in a rabbit model.

OBJECTIVE: The aim of this study was to investigate the preventive effect of halofuginone on posterior glottic stenosis (PGS) in an animal model. STUDY DESIGN: A randomized, controlled animal study. SUBJECTS AND METHODS: Sixteen male New Zealand White rabbits were used for this study. After the mucosa of posterior glottis was removed for producing PGS, the study group (eight rabbits) was given intraperitoneal halofuginone at 0.1 mg/kg/day for 4 weeks and saline was injected into peritoneum in the control group. At 4 weeks after injury, postsurgical changes of posterior glottis were evaluated by gross and histologic examination. RESULTS: PGS was induced by the mucosal stripping of the posterior glottis. The halofuginone-treated group showed less scarring and granulation tissue formation. Also, the degree of synechia was significantly less than that of control group. Histologic analysis showed the decreased fibrosis in the halofuginone-treated group. CONCLUSION: This study suggests that halofuginone can be helpful in preventing PGS after laryngeal injury.

Removal of pediatric branchial cleft cyst using a retroauricular hairline incision (RAHI) approach.

OBJECTIVE: Branchial cleft cyst (BCC) is treated surgically using a transcervical approach, leaving potential cervical scars. This prospective study assessed the outcomes of retroauricular hairline incision (RAHI) approach for BCC excision in children. METHODS: Twelve patients with second BCC (age < 18 years) underwent cyst excision via the RAHI approach, with incision along the postauricular sulcus and hairline. The operation time, complications, and subjective satisfaction with incision scars were assessed. RESULTS: Mean operation time was 45 +/- 12 min. There were no significant complications, except for temporary hypoesthesia of the earlobe. Hypertrophic scars at incision sites occurred in two patients, but these scars are usually hidden by the natural hair and auricle. Mean subjective satisfaction score regarding incision scars was 8.7 +/- 0.9 out of 10. CONCLUSIONS: The RAHI approach may provide good aesthetic results without significant surgical morbidities. This may be an alternative option for the surgical excision of BCC for children and their parents who desire invisible external scars after surgery.

Iatrogenic ear lobule ischemic injury from pressure dressing as an unusual complication of parotidectomy.

The use of compressive dressing is usually spread to enhance neovascularization of the dissected facial flap by elimination of dead space between the flap and the dermis in parotid surgery through facelift incision. The author reports a clinical case of compressive dressing after parotidectomy that was inappropriately performed to folding of the ear lobule, leading to ischemic injury. This iatrogenic complication resulted in the development of contracture of ear lobule and deformity of auricle. Consequently, careful compressive dressing after parotidectomy through facelift incision must be applied; and the wound must be inspected daily for early detection and prompt treatment of local complications.

Cervical sensory preservation during neck dissection.

Although the practice of neck dissection has greatly advanced from radical to function-preserving surgery, the impact of the sensory nerve-preserving neck surgery on the pain and quality of life (QOL) of patients has received little study. We evaluated neck morbidity and its impact on QOL associated with selective or modified radical neck dissection with or without preservation of cervical root branches. We conducted a retrospective cohort study comparing 24 patients who had their cervical root branches preserved to 29 patients whose root branches were removed during neck dissection. The spinal accessory nerve was preserved and sex, age, pathologic status, side and extent of neck dissection, and radiotherapy were comparable between groups. The groups were compared based on sensory and motor functions of the neck and shoulder and questionnaires on depression and QOL at follow-up of mean 18.7 (range 12-34) months after surgery. The nerve-preserved patients showed a low incidence and severity of neck and shoulder pain compared to the nerve-removed subjects (p<.05). Loss of sensation was more frequently experienced in the nerve-removed group on the earlobe and the lateral neck of the operated side (p<.05). Depression and QOL scores were higher in the nerve-removed group and significantly correlated with pain intensity. Preservation of the cervical root branches reduces postoperative pain as well as permanent anesthetic areas of the neck. This may also improve the mental state and QOL of patients undergoing neck dissection.

Effect of acid and pepsin on glottic wound healing: a simulated reflux model.

OBJECTIVE: To evaluate the effects of acid and pepsin on the healing of traumatized vocal folds in a simulated reflux model. Gastroesophageal reflux is related to various laryngeal manifestations. However, there is a lack of established reflux animal models that would ensure longer observation periods. DESIGN: A prospective randomized animal study. INTERVENTIONS: Forty-two rabbits underwent a stripping procedure of the unilateral glottis and catheter insertion under transoral endoscopic guidance. The animals were randomly assigned to a control group (n = 21; isotonic sodium chloride was used) or a reflux group (n = 21, acid and pepsin were used). They received intrapharyngeal catheter irrigation with 3 mL of isotonic sodium chloride or a solution of acid with a pH of 3 and pepsin, 0.3 mg/mL, twice daily for 4 or 8 weeks after surgery. MAIN OUTCOME MEASURES: Gross and histologic findings of the preinjured glottides of the 2 groups were compared. RESULTS: The catheter extrusion rate was significantly low (6%), and any catheter problems were immediately solved by reinsertion or reconnection. The extent of glottic scarring and frequency of granulation formation were higher in the reflux group compared with the control group (P<.05). Histologic inflammation scores and collagen deposition were significantly greater in the reflux group compared with the control group (P<.05). CONCLUSIONS: Our data suggest that glottic wound healing is significantly affected by acid and pepsin. Antireflux treatment can be advocated to minimize further injury caused by gastroesophageal reflux in patients who undergo laryngeal surgery.

Removal of nonthyroidal neck masses with improved cosmetic outcomes in skin-lifting surgery.

OBJECTIVE: To evaluate the cosmetic benefit of neck skin-lifting surgery for the removal of nonthyroidal neck masses. STUDY DESIGN AND SETTING: Fifty patients with neck masses were divided into the following 2 surgical groups that were matched in age, sex, and the size, location, and pathology of lesions: skin lifting (n = 25) and conventional (n = 25). The operation time, hospital stay, complications, and subjective satisfaction with the incision scar as assessed on a visual analogue scale (VAS) were compared between the 2 groups. RESULTS: All but 2 lesions (lymphomas) were benign and were removed completely, drained, or biopsied. The surgery time, hospital stay, and complication rates did not differ significantly between the groups. The mean satisfaction score of the patients was 8.2 +/- 1.1 in the skin-lifting surgery group and 4.8 +/- 2.5 in the controls (P < 0.001). The incision scars were commonly hidden by natural hair or collars in the patients who received skin-lifting surgery. CONCLUSION: This surgical technique can be safely applied to most benign masses in the entire neck excluding the thyroid region, especially in patients who prefer neck scars to be invisible. EBM RATING: B-2b.