Management of Patients with Cervicofacial Edema and Paresthesia during Perioperative Period of Transoral Endoscopic Thyroidectomy

Abstract

Objective. To analyze the clinical intervention effect of transoral endoscopic thyroidectomy on the neck and face during perioperative period. Method. From January 2019 to January 2020, 60 patients included in this study were randomly divided into observation group and control group according to the ratio of 1 : 1, with 30 cases in each group. Both groups underwent rapid surgical intervention during the perioperative period. The patients in the observation group received neck and face management. The degree of jaw swelling, the degree of facial microexpression completion, and the changes in jaw and neck sensation were compared between the two groups. Results. There was no significant difference in neck and face swelling, pain, facial microexpression, and feeling between the two groups before operation. Patients with facial I/II swelling degree in the observation group were significantly more than in the control group, and the patients with III swelling degree were less than in the control group. There was significant difference for facial swelling between the two groups in the three intervention periods after the operation, and the difference was statistically significant ( P < 0.05 ). The scores of facial microexpression in the observation group were higher than those in the control group during the three postoperative intervention periods, with statistical significance ( P < 0.05 ). There was no significant difference in the pain score of the first day after surgery between the two groups ( P = 0.298 ). In the other two postoperative intervention periods, the pain score of the observation group was lower than that of the control group, with a statistically significant difference, and the difference was statistically significant ( P < 0.05 ). The threshold of chin and neck sensory pressure in the two groups was statistically significant ( P < 0.05 ) except that the “cheek in area 4” ( P = 0.290 ). Conclusion. The results showed that these interventions, such as the elevation of bed after operation, 24-hour intermittent cryotherapy, ice cubes in mouth, and the “meter” functional training, have good clinical effects on the symptoms of facial swelling and abnormal sensation of neck and face. It can accelerate the speed of edema dissipation, improve the patients’ postoperative comfort, and improve the satisfaction and quality of life of patients with the effect of surgery and beauty.

Advances in the assessment of cosmetic outcomes, sensory alteration in surgical areas, and health-related quality of life of endoscopic thyroidectomy

“…Pain is typically localized in the cervical area and various surgical tunnels in different endoscopic approaches. In a study by Yang et al, the VAS scoring was used to assess pain in patients with cervicalofacial edema and paresthesia following transoral endoscopic thyroidectomy [ 38 ]. Several studies have compared postoperative pain levels between endoscopic and open thyroidectomy procedures, as well as different endoscopic approaches, using this pain scale [ 4 , 5 , 20 , 21 , 26 , 31 , 41 , 42 ].…”

“…Yang et al and Liang et al conducted assessments of paresthesia in the chin, face, and neck regions of patients who had undergone transoral thyroidectomy using the Semmes–Weinstein monofilament test. The patients were instructed to sit with their eyes closed, after which a nylon filament was applied perpendicularly to the designated area, bent into a C-shape [ 38 , 39 ]. The size of nylon and its representative in the study were as follows: 2.83 = 0.07 g/mm 2 (normal sensation), 3.61 = 0.4 g/mm 2 (hypotactile loss), 4.31 = 2 g/mm 2 (protective hypoesthesia), 4.56 = 4 g/mm 2 (protective loss of sensation), and 5.07 = 10 g/mm 2 (protective loss of sense).…”

“…The size of nylon and its representative in the study were as follows: 2.83 = 0.07 g/mm 2 (normal sensation), 3.61 = 0.4 g/mm 2 (hypotactile loss), 4.31 = 2 g/mm 2 (protective hypoesthesia), 4.56 = 4 g/mm 2 (protective loss of sensation), and 5.07 = 10 g/mm 2 (protective loss of sense). A loss of sensation was defined as the inability of patients to perceive the pressure when 10 g was applied [ 38 , 39 , 43 ].…”

“…It has been observed that varying degrees of numbness and sensory deficits in the mandibular region following a transoral thyroidectomy typically manifest after the postoperative pain and become more prominent within 1 to 3 months post-surgery. These symptoms typically resolve naturally within 6 months, but a failure to recover may indicate permanent paralysis of the mental nerve [ 38 , 39 ].…”

Retracted: Management of Patients with Cervicofacial Edema and Paresthesia during Perioperative Period of Transoral Endoscopic Thyroidectomy

“…This article has been retracted by Hindawi following an investigation undertaken by the publisher [ 1 ]. This investigation has uncovered evidence of one or more of the following indicators of systematic manipulation of the publication process: Discrepancies in scope Discrepancies in the description of the research reported Discrepancies between the availability of data and the research described Inappropriate citations Incoherent, meaningless and/or irrelevant content included in the article Peer-review manipulation …”