Reducing neck incision length during thyroid surgery does not improve satisfaction in patients

Abstract

Postoperative neck cosmesis is a major concern of patients undergoing thyroid surgery. Patients will likely be more satisfied with the long-term cosmetic appearance of smaller than larger thyroidectomy scars. We, therefore, investigated the relationship between scar length following conventional thyroid surgery and patient satisfaction. An anonymous scar-assessment questionnaire was administered to patients who underwent conventional thyroid surgery. The 2,041 patients were asked to rate their satisfaction with their scars on a ten-point Likert scale, with one being very unsatisfied and ten being very satisfied. The mean satisfaction score was significantly lower in the benign condition than in malignancy (6.9 ± 2.5 vs. 7.4 ± 2.5; p = 0.021), whereas there were no differences in satisfaction score among subgroups of patients with benign condition (p = 0.837). In patients with thyroid cancer, the mean satisfaction scores were similar among subgroups according to operation type and scar length (p = 0.820). Incision length was not associated with patient satisfaction in thyroid surgery patients and therefore may not be critical in decision making for thyroid cancer surgery.

Transoral neck surgery prevents attentional bias towards the neck compared to open neck surgery

“…[23][24][25] In fact, Kim et al showed that reducing the scar length did not improve patient satisfaction. 26 Another study specifically investigated scar type rather than length and did not find an association with satisfaction either, suggesting that the mere presence of a scar can affect quality of life. 27 Intriguingly, these researchers also noted that patients rated postoperative neck scars to be as impairing as chronic skin diseases such as psoriasis and severe atopic eczema.…”

A paired comparison analysis of third-party rater thyroidectomy scar preference

“…22 Kim et al similarly found no correlation between scar length and patient satisfaction with cosmesis in a large series of 1836 patients undergoing total or less than total thyroidectomy with a mean scar length of 5.8 cm (standard deviation = 2.2). 24 Like some of the previous investigations, applicability of these two studies is limited because they used a 10-point self-assessment scale without any frame of reference to determine cosmetic acceptability. O'Connell et al compared scar cosmesis in patients who had undergone minimal access parathyroidectomy (n = 11, mean scar length = 3.4 cm) with sex-and agematched controls who had undergone conventional parathyroidectomy or thyroidectomy (n = 11, mean scar length = 7.6 cm).…”

Patientenzufriedenheit nach Thyreoidektomie – die Breite der Narbe ist wichtiger als die Länge

“…Die Datenlage ist bisher nicht eindeutig, ob eine Reduzierung der Narbenlänge oder eine Vermeidung der Narbe am Hals durch Verwendung eines alternativen Verfahrens einen relevanten Einfluss auf die Patientenzufriedenheit hat [16,17]. Während einige Autoren berichten, dass die Narbenlänge eher keinen Einfluss auf die Patientenzufriedenheit hat, ist weiterhin unklar, was die wesentlichen Faktoren für eine hohe Zufriedenheit sind [18,19].…”