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Updated: May 24, 2026
Transoral Endoscopic Thyroidectomy Vestibular Approach for Thyroid Lobectomy
Published on: May 12, 2023
Comparison of incidence of postoperative seroma between flapless and conventional techniques for thyroidectomy: a
P Sheahan1, A O'Connor, M S Murphy
1Department of Otolaryngology-Head & Neck Surgery, South Infirmary Victoria University Hospital, Cork, Ireland. sheahan.patrick@sivuh.ie
Objectives:
The incidence of seroma after thyroidectomy has been reported between 1.3% and 7%. We hypothesised that a flapless thyroidectomy technique would reduce the incidence of seroma.
Design:
Observational case-control study with comparison between retrospective cohort of patients undergoing thyroidectomy with raising of conventional skin flaps and prospective cohort undergoing flapless surgery.
Setting:
Academic Teaching Hospital.
Participants:
Hundred and seventy-five consecutive patients undergoing thyroidectomy performed by a single surgeon. After the first 85 cases, a change in practice took place, from raising of conventional skin flaps to performing flapless surgery wherever feasible.
Main Outcome Measures:
Occurrence of postoperative seroma, defined as central neck swelling in postoperative period, confirmed by aspiration of serous fluid, and other complications.
Results:
Eight patients who underwent concomitant lateral (jugular) neck dissection were excluded. Among the remaining 167 patients, there were eight seromas (5%). Following the change in practice to flapless surgery, there was a significant reduction in the incidence of seroma (P = 0.025). There was no significant difference in other complications (haematoma; recurrent laryngeal nerve injury; and hypocalcaemia). Among the entire group, the association between seroma and flapless surgery tended towards significance (P = 0.07). Other variables studied, including use of drain and concomitant central compartment neck dissection, had no effect on seroma.
Conclusion:
Flapless technique for thyroid surgery may reduce the incidence of postoperative seroma.
