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Updated: Dec 21, 2025
Transoral Endoscopic Thyroidectomy Vestibular Approach for Thyroid Lobectomy
Published on: May 12, 2023
U-shaped strap muscle flap for difficult thyroid surgery
How-Yun Ko1, I-Cheng Lu2,3, Pi-Ying Chang3
1Department of Otolaryngology-Head and Neck Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Background:
Open thyroidectomy via conventional midline approach can be challenging in complex thyroid surgeries. This study proposes a U-shaped strap muscle flap (USMF) technique that provides adequately wide exposure of the surgical field.
Methods:
Strap muscles were cut close to the clavicle and along the anterior margin of both sternocleidomastoid muscles followed by total thyroidectomy in 20 patients as USMF group, and surgical outcomes were compared with 40 patients who had received total thyroidectomy via midline approach.
Results:
No patient had postoperative hematoma, vocal cord paralysis, permanent hypocalcaemia, wound infection or flap necrosis. At 2 months post-surgery, objective voice analysis and subjective assessment of voice and swallowing showed no significant difference between groups.
Conclusions:
USMF provides superb surgical field exposure, and the voice and swallowing functions after USMF are comparable to those obtained by midline approach. The USMF approach is a feasible option for selective difficult thyroid surgery.
