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Comparison of postoperative cosmesis in transaxillary, postauricular facelift, and conventional transcervical thyroidectomy

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Abstract

Background

The most important advantage of remote-access robotic and endoscopic thyroidectomies is believed to be the excellent postoperative cosmesis. The purpose of this study was to compare directly the postoperative cosmetic outcomes of robotic/endoscopic thyroidectomy via gasless transaxillary and postauricular facelift approaches with those of conventional thyroidectomy.

Methods

We prospectively studied 100 patients who underwent robotic/endoscopic thyroidectomy using a gasless unilateral axillary (GUA) approach (50 patients) or a postauricular facelift approach (50 patients), and 50 who underwent conventional transcervical thyroidectomy. Postoperative cosmetic satisfaction scores and scar consciousness scores were evaluated at 3 months and 1 year after surgery using questionnaires developed by us. Vancouver scar scales were evaluated at the same time. The cosmetic satisfaction score was defined as the sum of the two cosmetic satisfaction questions with a rating scale of 1–5 each. The scar consciousness score was defined as the sum of the four scar consciousness questions with a rating scale of 0–3 each.

Results

The cosmetic satisfaction and scar consciousness scores were significantly lower (corresponding to greater satisfaction) in the transaxillary and postauricular facelift groups than the conventional group at 3 months and 1 year postoperatively. They did not differ between the transaxillary and postauricular facelift groups. However, the Vancouver scar scale score of the conventional group was significantly lower than those of the transaxillary and postauricular facelift groups (P < 0.001 in both).

Conclusion

Robotic/endoscopic thyroidectomy via transaxillary or postauricular facelift approaches results in better cosmesis than the conventional approach. However, scar healing itself is worse in the transaxillary and facelift approaches than the conventional approach.

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Authors and Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea

    Dong Won Lee, Seok Hwa Ko, Chang Myeon Song, Yong Bae Ji & Kyung Tae

  2. Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Catholic University of Daegu, Daegu, Republic of Korea

    Dong Won Lee & Jeong Kyu Kim

Authors
  1. Dong Won Lee
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  2. Seok Hwa Ko
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  3. Chang Myeon Song
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  4. Yong Bae Ji
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  5. Jeong Kyu Kim
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  6. Kyung Tae
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Correspondence to Kyung Tae.

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Disclosures

Dong Won Lee, Seok Hwa Ko, Chang Myeon Song, Yong Bae Ji, Jeong Kyu Kim, and Kyung Tae have no conflicts of interest or financial ties to disclose.

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Lee, D.W., Ko, S.H., Song, C.M. et al. Comparison of postoperative cosmesis in transaxillary, postauricular facelift, and conventional transcervical thyroidectomy. Surg Endosc 34, 3388–3397 (2020). https://doi.org/10.1007/s00464-019-07113-1

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  • DOI: https://doi.org/10.1007/s00464-019-07113-1

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