Combination of Surgical Subcision and Intralesional Corticosteroid Injection As a Cost-Effective and Minimally Invasive Treatment for Postoperative Adhesive Thyroidectomy Scars

Abstract

BACKGROUND: Postoperative adhesive symptoms (swallowing difficulty or pulling sensation during neck extension) are one of the major complications of thyroidectomy. Moreover, adhesive scars are often visible and cause cosmetic concerns. OBJECTIVE: To evaluate the efficacy and safety of combined treatment with surgical subcision and intralesional corticosteroid injection for postoperative adhesive thyroidectomy scars. METHODS: A retrospective analysis was performed of 16 Korean patients with postoperative adhesive thyroidectomy scars treated with three sessions of surgical subcision and intralesional corticosteroid injection. RESULTS: The Vancouver Scar Scale score decreased significantly after treatment (P < .001). Follow-up revealed that six of the 16 patients (37.5%) had clinical improvement of 51% to 75%, six (37.5%) had moderate clinical improvement of 26% to 50%, and three (18.8%) had improvement of 76% to 100%; one patient (6.3%) demonstrated minimal to no improvement. After three sessions of treatment, the mean clinical improvement grade was 2.68, which means moderate to marked improvement compared to before treatment. Post-treatment erythema was observed in most patients, and notable bruising after treatment observed in five patients resolved spontaneously within 7 days. CONCLUSION: Combined treatment with surgical subcision and intralesional corticosteroid injection is a cost-effective and minimally invasive treatment for postoperative adhesive thyroidectomy scars.