DATE: @TD@
PATIENT NAME: @NAME@ 


PREOPERATIVE DIAGNOSIS: 
***

POSTOPERATIVE DIAGNOSIS: 
Same

OPERATION: 
***

SURGEON: William Morrel, MD 

ANESTHESIA: General 

INDICATIONS FOR PROCEDURE:  
***

FINDINGS:  
***

DESCRIPTION OF PROCEDURE
After informed consent had been obtained, the patient was brought to the operating room and general anesthesia was induced. The patient was intubated and the bed was turned 180 degrees. A ***-cm right neck incision was marked out in a neck crease near the level of the hyoid bone, at the inferior border of the mass. The planned incision was marked on either side with methylene blue using an 18 gauge needle and was injected with *** mL of 1% lidocaine with 1:100,000 epinephrine. The patient was prepped with Betadine and draped in the standard fashion. 

A surgical time-out was performed. The planned incision was made on the *** with a 15 blade. A sub-platysmal flap was raised superiorly to the level of the mandible and inferiorly approximately 3 cm. The external jugular vein and great auricular nerve were identified and preserved. Dura hooks were used to maintain visualization. The cystic mass was found anterior to the sternocleidomastoid muscle and carefully separated from this muscle. This posterior border had some inflammation and fibrosis***. The superficial surface was dissected down onto the mass to preserve the marginal mandibular nerve, which was seen and reflected superiorly. The mass freed easily off the mandible. The anterior and inferior portions of the mass were bluntly dissected out. The deep surface of the mass freed easily off the internal jugular and posterior facial veins. The hypoglossal nerve was identified and preserved. No tract was seen extending from either the superficial or deep surfaces of the mass. Once the mass was completely excised, it was sent as a permanent specimen measuring approximately *** cm. 

The surgical site was irrigated and hemostasis obtained. A 7 French round, perforated drain was placed, brought out posterior to the incision, and sutured in place. The platysma was closed with 3-0 Vicryl. The skin was closed with 4-0 Monocryl. Mastisol and 1/4-inch steri strips were applied to the incision.

The patient tolerated the procedure well and was turned over to Anesthesia, awakened, and extubated. There were no acute complications.

ESTIMATED BLOOD LOSS: *** mL
 
COMPLICATIONS: None ***

SPECIMENS: ***

DISPOSITION:
The patient was transferred to the recovery room in stable condition.