Grunenwald approach for the area around the internal jugular vein angle

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  • Masuda Muneyuki
    Department of Head and Neck Surgery, National Kyushu Cancer Center
  • Aso Takeichiro
    Department of Otolaryngology and Head and Neck Surgery, Kurume University
  • Wakasaki Takahiro
    Department of Head and Neck Surgery, National Kyushu Cancer Center
  • Omori Hirofumi
    Department of Head and Neck Surgery, National Kyushu Cancer Center
  • Rikimaru Fumihide
    Department of Head and Neck Surgery, National Kyushu Cancer Center
  • Toh Satoshi
    Department of Head and Neck Surgery, National Kyushu Cancer Center
  • Higaki Yuichiro
    Department of Head and Neck Surgery, National Kyushu Cancer Center

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Other Title
  • Grunenwald法による内頸静脈角周囲へのアプローチ
  • ―胸骨切開・胸骨除去との比較―
  • ― comparison with sternotomy or removal of the bony thorax

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When a head and neck tumor invades the upper lateral mediastinum, partial sternotomy （e.g., L shape） is not sufficient to gain a good surgical view, while removal of part of the bony thorax causes cosmetic and functional problems. The Grunenwald approach, in which bones around the sternoclavicle joint are temporary mobilized and replaced back to the physiological position following required surgery, appears to be an excellent method that can address these issues. However, there are only a few reports about the application of this approach to head and neck tumor. We recently used this technique to remove two head and neck tumors, which required handling of the venus angle and the subclavian and innominate veins, and favorable results were obtained. We here describe the advantages of this method mainly focusing on the comparison of the surgical views obtained by sternotomy or removal of the bony thorax.

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