Novel approach to thyroid skin incision with tunnel dissection technique

Abstract

Aim: Superior and inferior flaps beneath the platysmal layer have been used to open the midline raphe in thyroidectomy. Sometimes this flap dissection causes some serious complications, such as seroma and subcutaneous haematoma formation. Here, we described a new approach for flapless thyroidectomy. Patients and Methods: A total of 289 patients who underwent thyroidectomy were eligible for the study. Group 1 was the control group. In group 2, a 5-mm wide tunnel from the thyroid cartilage superiorly to the sternal notch was inferiorly used to open the midline raphe. Patient demographics and complications were recorded and compared. Results: Specimen volumes, skin incision lengths and operation times of the groups were 69.83±37.72mL and 71.17±48.28mL, 3.80±0.89cm and 3.96±0.76cm and 115.21±26.73min and 117.32±27.25min, respectively (P=0.785, P=0.196 and 0.875, respectively). Permanent recurrent laryngeal nerve palsy and permanent or temporary hypocalcaemia were similar (P=0.137, P=0.459 and P=0.333). Seroma and subcutaneous haematoma were significantly higher in group 1 (P=0.024). Conclusion: This less traumatic approach is a technically feasible and an alternative to conventional flap dissection with any limitations. © 2012 The Authors. Surgical Practice © 2012 College of Surgeons of Hong Kong.