{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T21:01:31Z","timestamp":1784667691691,"version":"3.55.0"},"reference-count":8,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:00:00Z","timestamp":1777939200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:00:00Z","timestamp":1777939200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005719","name":"Dicle University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005719","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Arch Otorhinolaryngol"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To describe a modified apron (Akil) incision technique designed to prevent postoperative subcutaneous emphysema in patients undergoing open partial laryngectomy by maintaining an anatomical barrier between the laryngectomy field and the tracheostomy site.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study presents a technical modification applied in patients undergoing open partial laryngectomy, including supracricoid partial laryngectomy and partial verticallaryngectomy. The incision begins bilaterally at the mastoid tips, extends inferiorly along the anterior border of the sternocleidomastoid muscle, and terminatesapproximately 2 cm above the sternal notch. Unlike the conventional apron incision, an intact full-thickness skin bridge (approximately 2\u20132.5 cm in height) is preservedwithout undermining. All laryngeal framework procedures are performed superior to this bridge, while the tracheostomy is created inferiorly, preventing directcommunication between the two surgical fields.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 23 patients were included. None developed clinically significant subcutaneous emphysema requiring intervention. Minor complications included one wound infection, one seroma managed with drainage and compression, and one case of partial wound dehiscence requiring revision. No complications were directly attributable to the incision design.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The modified Akil incision provides a simple and effective anatomical barrier that may reduce the risk of postoperative subcutaneous emphysema following open partial laryngectomy. This technique is easily reproducible and may improve postoperative outcomes without increasing complication rates.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00405-026-10186-z","type":"journal-article","created":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T15:52:14Z","timestamp":1777996334000},"page":"4755-4758","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The modified apron (Akil) incision: a technical modification to prevent subcutaneous emphysema in partial vertical and supracricoid laryngectomy"],"prefix":"10.1007","volume":"283","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5479-9311","authenticated-orcid":false,"given":"Ferit","family":"Ak\u0131l","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7495-4745","authenticated-orcid":false,"given":"Ahmet","family":"\u00c7elik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,5]]},"reference":[{"issue":"2","key":"10186_CR1","doi-asserted-by":"publisher","first-page":"647","DOI":"10.1378\/chest.121.2.647","volume":"121","author":"P -Beck","year":"2002","unstructured":"Beck P, Heitman S, Mody C (2002) Simple construction of a subcutaneous catheter for treatment of severe subcutaneous emphysema. Chest 121(2):647\u2013649","journal-title":"Chest"},{"issue":"1","key":"10186_CR2","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1007\/BF00258069","volume":"10","author":"RTN -Gibney","year":"1984","unstructured":"Gibney RTN et al (1984) Upper airway obstruction caused by massive subcutaneous emphysema. Intensive Care Med 10(1):43\u201344","journal-title":"Intensive Care Med"},{"issue":"3","key":"10186_CR3","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1016\/0030-4220(91)90298-Q","volume":"71","author":"JA -Anderson","year":"1991","unstructured":"Anderson JA et al (1991) Subcutaneous emphysema producing airway compromise after anesthesia for reduction of a mandibular fracture: a case report and review of the literature. Oral surgery, oral medicine. oral Pathol 71(3):275\u2013279","journal-title":"oral Pathol"},{"issue":"5","key":"10186_CR4","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1002\/hed.20738","volume":"30","author":"JS -Lewin","year":"2008","unstructured":"Lewin JS, Hutcheson KA, Barringer DA, May AH, Roberts DB, Holsinger FC, Diaz EM Jr. (2008) Functional analysis of swallowing outcomes after supracricoid partial laryngectomy. Head Neck 30(5):559\u2013566. https:\/\/doi.org\/10.1002\/hed.20738","journal-title":"Head Neck"},{"key":"10186_CR5","doi-asserted-by":"publisher","DOI":"10.1007\/s12672-025-04216-1","author":"M Shi","year":"2025","unstructured":"Shi M et al (2025) Incidence, severity, and risk factors of early postoperative complications in laryngectomy patients: a retrospective analysis. Discover Oncol. https:\/\/doi.org\/10.1007\/s12672-025-04216-1","journal-title":"Discover Oncol"},{"issue":"4","key":"10186_CR6","doi-asserted-by":"publisher","first-page":"314","DOI":"10.1177\/000348940511400411","volume":"114","author":"KT -Brumund","year":"2005","unstructured":"Brumund KT, Gutierrez-Fonseca R, Garcia D, Babin E, Hans S, Laccourreye O (2005) Frontolateral vertical partial laryngectomy without tracheotomy for invasive squamous cell carcinoma of the true vocal cord: a 25-year experience. Ann Otol Rhinol Laryngol 114(4):314\u2013322 https:\/\/doi.org\/10.1177\/000348940511400411","journal-title":"Ann Otol Rhinol Laryngol"},{"issue":"Suppl 2","key":"10186_CR7","doi-asserted-by":"publisher","first-page":"673","DOI":"10.1007\/s12262-013-0975-4","volume":"77","author":"M -Aghajanzadeh","year":"2015","unstructured":"Aghajanzadeh M, Dehnadi A, Ebrahimi H, Fallah Karkan M, Khajeh Jahromi S, Amir Maafi A, Aghajanzadeh G (2015) Classification and management of subcutaneous emphysema: a 10-year experience. Indian J Surg 77(Suppl 2):673\u2013677","journal-title":"Indian J Surg"},{"issue":"2","key":"10186_CR8","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1177\/014107680209500210","volume":"95","author":"Y -Abu-Omar","year":"2002","unstructured":"Abu-Omar Y, Catarino P (2002) Progressive subcutaneous emphysema and respiratory arrest. J R Soc Med 95(2):90\u201391","journal-title":"J R Soc Med"}],"container-title":["European Archives of Oto-Rhino-Laryngology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00405-026-10186-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00405-026-10186-z","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00405-026-10186-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T20:06:11Z","timestamp":1784664371000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00405-026-10186-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,5]]},"references-count":8,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10186"],"URL":"https:\/\/doi.org\/10.1007\/s00405-026-10186-z","relation":{},"ISSN":["0937-4477","1434-4726"],"issn-type":[{"value":"0937-4477","type":"print"},{"value":"1434-4726","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,5]]},"assertion":[{"value":"15 February 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 March 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"No conflict of interest was declared by the authors.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}}]}}