Abstract
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.
