Comparison of postoperative cosmesis in transaxillary, postauricular facelift, and conventional transcervical thyroidectomy

Lee, Dong Won; Ko, Seok Hwa; Song, Chang Myeon; Ji, Yong Bae; Kim, Jeong Kyu; Tae, Kyung

doi:10.1007/s00464-019-07113-1

Cited by 41 publications

(47 citation statements)

References 33 publications

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“…This is despite the nding that an anterior cervical neck scar can negatively impact patient quality of life. Many extra-cervical approaches to the thyroid have been described to circumvent anterior neck scarring, including the transaxillary, robotic-facelift, and transoral endoscopic vestibular approaches [12][13][14][15]. These incisions are only subtle and not truly scar-free.…”

Section: Discussionmentioning

confidence: 99%

A Comparative Study of Two Robotic Thyroidectomy Procedures: Transoral Vestibular Versus Bilateral Axillary-Breast Approach

Zhu

et al. 2022

Preprint

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Objective: To compare the surgical outcomes between the transoral-vestibular robotic thyroidectomy (TOVRT) and bilateral axillo-breast approach robotic thyroidectomies (BABART).Methods: A total of 99 patients with papillary thyroid carcinoma without distant metastasis were enrolled in this study from May 2020 to April 2021. 99 patients had received an ultrasound guided fine needle aspiration prior to surgical intervention so the appropriate procedure can be planned. 49 patients underwent TOVRT, and another 50 patients underwent BABART. We performed TOVRT using three intraoral ports or adding the right axillary fold incision to enhance fine countertraction of tissue for radical oncological dissection. The clinical data such as age, gender, height, weight, BMI, primary tumor size, number of central lymph node removed, central lymph node metastasis, operating time, total hospital stays, postoperative hospital stays, total postoperative drainage volume, postoperative pain score, cosmetic effect and complications were observed and analyzed. Results: There were no significant differences in gender, height, weight, BMI and removed central lymph nodes between the two groups (all P > 0.05). Lobectomy or total thyroidectomy with central lymph node dissection using two different robotic thyroidectomy approaches were performed in 99 cases. In all cases, we used intraoperative neuro-monitoring system and confirmed that all RLNs were preserved. All patients had papillary thyroid carcinomas (PTC)． Patients accepted TOVRT were younger than who accepted BABART and patients who accepted TOVRT had smaller primary tumor size. The TOVRT group had a longer surgical time than the BABART group, and was superior in postoperative drainage volume and cosmetic effect (visual analogue scale, VAS)(all P < 0.05). There was no significant difference in lymph node metastasis, hospital stay and postoperative pain score (numerical rating scale, NRS) between the two groups (P > 0.05). However, there were some peculiar complications such as paresthesia of the lower lip and the chin (one case), surgical site infection (one case) and skin burn (one case) in transoral thyroidectomy. Conclusion: Transoral-vestibular robotic thyroidectomy is safe and feasible for selected patients, which is a potential alternative approach for patients who require no scarring of the neck.

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Section: Discussionmentioning

confidence: 99%

A Comparative Study of Two Robotic Thyroidectomy Procedures: Transoral Vestibular Versus Bilateral Axillary-Breast Approach

Zhu

et al. 2022

Preprint

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“…There is still limited information on scar perception following neck surgeries. One recent study investigated postoperative cosmesis of transaxillary, postauricular facelift, and TCA thyroidectomy, with findings that cosmetic satisfaction was greater in the transaxillary and postauricular facelift groups than TCA 16 . Given that the primary benefit of TOETVA is cosmetic, there is a need for an objective study comparing cosmetic outcomes between TCA and TOETVA.…”

Section: Discussionmentioning

confidence: 99%

“…These include transaxillary, postauricular‐occipital, and chest/breast approaches 6‐15 . While these approaches relocate the scar to a less conspicuous area, they also subject the patient to morbidity not typically associated with thyroid surgery 4,5,16 …”

Section: Introductionmentioning

confidence: 99%

Cosmetic outcomes following transoral versus transcervical thyroidectomy

et al. 2020

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Background: Central neck scars following thyroidectomy can negatively impact patient quality of life. Transoral endoscopic thyroidectomy can reduce postoperative cosmetic burden. Methods: Prospective cohort study of patients seen between June 2018 and January 2019. Scar cosmesis was determined using the validated Scar Cosmesis Assessment and Rating (SCAR) scale and a Visual Analog Scale (VAS) measuring color, contour, and irregularity. Results: Eighty-one patients (80% female, mean age 43.7 years) were analyzed, with 60% and 40% receiving transcervical and transoral thyroidectomy. Median time from surgery was 3.4 (range: 1-37.1) weeks. Mean SCAR score was greater for transcervical recipients (4.69 vs transoral 0.99, P < .001), indicating worse cosmesis. Mean surgeon-rated total VAS score was similarly increased for transcervical recipients (72.84 vs transoral 16.73, P < .001). Interrater reliability for both SCAR and total VAS scores was excellent (intraclass correlation 0.93; 95% CI: 0.90-0.95 for both). Conclusion: Transoral thyroidectomy provides significantly enhanced early cosmesis over the transcervical approach.

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“…Endoscopic thyroid surgery, also called remote-access thyroidectomy, has obvious advantages over conventional surgical techniques in terms of postoperative cosmetic outcome[ 1 ]. Endoscopic thyroidectomy was first reported in 1997.…”

Section: Introductionmentioning

confidence: 99%

Asymptomatic carbon dioxide embolism during transoral vestibular thyroidectomy: A case report

Tang¹,

Nian²,

Tang³

et al. 2021

WJCC

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BACKGROUND Endoscopic thyroidectomy has obvious advantages over conventional surgical techniques in terms of postoperative cosmetic outcome. Although the incidence of carbon dioxide embolism (CDE) during endoscopic thyroidectomy is very low, it is potentially fatal. The clinical manifestations of CDE vary, and more attention should be paid to this disorder. CASE SUMMARY A 27-year-old man was scheduled for thyroidectomy by the transoral vestibular approach. The patient had no other diseases or surgical history. During the operation, he developed a CDE following inadvertent injury of the anterior jugular vein. The clinical manifestation in this patient was a transient sharp rise in end-tidal carbon dioxide, and his remaining vital signs were stable. In addition, loud coarse systolic and diastolic murmurs were heard over the precordium. The patient was discharged on day 4 after surgery without complications. CONCLUSION A transient sharp rise in end-tidal carbon dioxide is considered a helpful early sign of CDE during endoscopic thyroidectomy.

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Comparison of postoperative cosmesis in transaxillary, postauricular facelift, and conventional transcervical thyroidectomy

Cited by 41 publications

References 33 publications

A Comparative Study of Two Robotic Thyroidectomy Procedures: Transoral Vestibular Versus Bilateral Axillary-Breast Approach

A Comparative Study of Two Robotic Thyroidectomy Procedures: Transoral Vestibular Versus Bilateral Axillary-Breast Approach

Cosmetic outcomes following transoral versus transcervical thyroidectomy

Asymptomatic carbon dioxide embolism during transoral vestibular thyroidectomy: A case report

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