Subcutaneous translocation of residual thyroid tissue: a novel functional-preserving technique for partial...

Benign thyroid nodules frequently require surgical intervention. Balancing thyroid‑function preservation and re‑operation‑related neuro‑parathyroidal risk represents an unmet clinical challenge. This study aimed to investigate the feasibility of translocating residual normal thyroid tissue into the subcutaneous space after resection of benign thyroid tumors. Conventional thyroid resection commonly compromises native thyroid function and leads to postoperative hypothyroidism. Residual thyroid tissue retained in the neck complicates surveillance and increases risks to the recurrent laryngeal nerve and parathyroid glands during secondary surgery. Although subcutaneous translocation may preserve thyroid function and simplify follow-up, its efficacy and safety require further verification.

This single-center retrospective analysis included 106 eligible patients with benign thyroid tumors who underwent partial thyroidectomy with residual gland translocation between May 2022 and May 2025. Ninety-four patients underwent unilateral resection, and 12 underwent bilateral resection. Residual normal tissue was transposed into the superficial subcutaneous muscular space through the sternocleidomastoid-sternohyoid muscle junction. Prespecified outcomes comprised postoperative thyroid function and ultrasound-confirmed graft viability. Thyroid function was measured by chemiluminescence assay and neck ultrasonography was used to assess graft status. Evaluations were scheduled at 1 month and 1 year postoperatively.

All 106 enrolled patients completed the 1-month postoperative follow-up, and all attended the 1-year follow-up. The cohort consisted of 94 patients receiving unilateral partial thyroidectomy and 12 receiving bilateral partial thyroidectomy. Mild localized anterior neck swelling was observed in several patients at 1 month. Ultrasound confirmed the location and size of translocated thyroid tissue. Thyroid function was normal in all 94 patients with unilateral resection. Among the 12 patients with bilateral resection, 5 developed hypothyroidism and required levothyroxine supplementation. At 1 year postoperatively, cervical appearance was unremarkable, and ultrasound showed no abnormal lesions in transposed tissue. Thyroid function normalized under hormone replacement in the 5 patients. The remaining 101 patients sustained normal thyroid function without levothyroxine therapy.

Based on the 1-year follow-up outcomes of this single-center, uncontrolled retrospective case series, subcutaneous translocation of residual normal thyroid tissue during partial thyroidectomy for benign tumors is feasible and effective in preserving short-term thyroid function and maintaining satisfactory cosmetic outcomes in this patient cohort. The potential benefit of reducing recurrent laryngeal nerve and parathyroid gland injury during reoperation remains theoretical and cannot be verified with current limited data; longer-term follow-up and controlled studies are required to confirm its long-term efficacy and safety.