[Application of an extended collar incision in neck dissection for differentiated thyroid cancer]

To explore a cosmetic incision in the neck dissection for differentiated thyroid carcinoma.

An extended collar incision was used for neck dissection in 82 consecutive patients with thyroid carcinoma from May 1999 to December 2006. The incision was designed to start as a conventional thyroid collar incision, and then to extend it along the skin crease to the anterior border of trapezium, so to avoid the vertical limb of conventional hockey stick incision. There were 60 females and 22 males in this series, with a median age of 40.5 years (range, 10 to 80 years). Ninety-six procedures of neck dissection were performed in 82 patients, including one radical neck dissection, one type I modified neck dissection, 8 type II modified neck dissections, and 86 type III modified neck dissections.

The average time of anesthesia was 197 minutes. The average dissected lymph nodes were 37.5, with average metastasis in 8.8 nodes. Eight patients (9.8%) developed complications related to neck dissection. The follow-up period in these patients were 1 to 96 months with a median follow-up time of 23 months. Cervical recurrence was found in only one patient (1.2%). Neither death nor distant metastasis was observed in this series.

It is feasible to perform a modified neck dissection for differentiated thyroid cancer through the extended collar incision. The preliminary results show that the above described incision is not only oncologically safe, but also offers a cosmetic benefit for the patient with thyroid carcinoma.