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Anatomical study of gasless transoral thyroidectomy and clinical application

Authors
 Hun-Mu Yang  ;  Kang-Jae Shin  ;  Junwon Min  ;  Seung Hoon Woo 
Citation
 SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, Vol.34(8) : 3414-3423, 2020-08 
Journal Title
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
ISSN
 0930-2794 
Issue Date
2020-08
Keywords
Anatomy ; Complication ; Nerve ; Scar ; Surgery ; Thyroid ; Thyroidectomy
Abstract
Background: Transoral thyroidectomy is becoming a preferred technique because it has the advantage of not leaving a scar after surgery. However, it is not yet standard because of the anatomic nerve complexity of this oral cavity and difficulty of approach. The aim of this study was to determine the safety zone of a gasless transoral thyroidectomy approach using an anatomical study and to evaluate the efficacy of this approach on clinical application.

Methods: Phase 1, twenty unilateral specimens from fresh cadavers underwent staining by the modified Sihler's method to identify nerves around the oral vestibules. Then, the safety zone of the transoral thyroidectomy approach was proposed. Phase 2, a comparative analysis of the clinical outcomes of gasless transoral thyroidectomy through the safety zone versus transcutaneous thyroidectomy approach.

Results: In phase 1, numerous inferior labial branches diverged from the mental nerve and were distributed across the lower lip. In most cases, the most lateral branch reached almost to the corner of the mouth, whereas a nerve-free area was present at the medial region of the lower lip. The suggested safety zone was presented as a trapezoid shape. In phase 2, there were no significant differences in age, mass size, or complications between the two groups. However, the operation time in the transoral thyroidectomy group was longer than in the transcutaneous group (p = 0.001).

Conclusions: Based on the anatomical study, we suggested a safety zone for the gasless transoral thyroidectomy. On application of this safety zone, gasless transoral thyroidectomy is a safe and feasible procedure.
Full Text
https://link.springer.com/article/10.1007%2Fs00464-019-07117-x
DOI
10.1007/s00464-019-07117-x
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anatomy (해부학교실) > 1. Journal Papers
Yonsei Authors
Yang, Hun Mu(양헌무) ORCID logo https://orcid.org/0000-0003-1954-0114
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/179684
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