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Published on: May 12, 2023
Minimal Endoscope-assisted Thyroidectomy Through a Retroauricular Approach: An Evolving Solo Surgery Technique
Myung Jin Ban1, Jae Won Chang, Won Shik Kim
1*Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Cheonan †Department of Medicine, The Graduate School of Yonsei University §Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul ‡Department of Otorhinolaryngology, Chungnam National University College of Medicine, Daejeon, Korea.
Minimal endoscope-assisted thyroidectomy (MEAT) via a retroauricular approach is feasible and safe. This technique allows for solo thyroidectomy, overcoming space limitations and reducing instrument interference for better surgical outcomes.
Area of Science:
- Surgical Oncology
- Endocrine Surgery
- Minimally Invasive Surgery
Background:
- Retroauricular (RA) approaches offer aesthetic advantages for thyroidectomy.
- Endoscopic assistance can enhance visualization and precision in thyroid surgery.
- Challenges in RA thyroidectomy include limited working space and instrument maneuverability.
Purpose of the Study:
- To evaluate the feasibility and efficacy of minimal endoscope-assisted thyroidectomy (MEAT) using a retroauricular (RA) approach.
- To assess the safety and outcomes of MEAT in patients with papillary thyroid carcinoma.
- To determine if solo thyroidectomy via the RA approach is viable without constant endoscopic guidance.
Main Methods:
- MEAT was performed in 8 patients with papillary thyroid carcinoma (mean tumor size, 1.2±0.5 cm).
- Direct visualization through the RA window was prioritized, with endoscope use limited to critical structures.
- Recurrent laryngeal nerve neuromonitoring was employed throughout the procedure.
Main Results:
- The mean endoscopic operating time was 19±3.4 minutes.
- No postoperative complications such as hematoma, seroma, or vocal cord paralysis were observed.
- The technique proved feasible and safe, with successful preservation of critical structures.
Conclusions:
- Minimal endoscope-assisted thyroidectomy through a retroauricular approach is a safe and feasible surgical option.
- This technique effectively overcomes the limitations of working space and instrument interference.
- Solo thyroidectomy via the RA approach is achievable, offering a viable alternative for endocrine surgeons.
