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- Title
Hidden in Plain Sight: Transoral and Submental Thyroidectomy as a Compelling Alternative to "Scarless" Thyroidectomy.
- Authors
Chen, Yufei; Chomsky-Higgins, Kathryn; Nwaogu, Iheoma; Seib, Carolyn D.; Gosnell, Jessica E.; Shen, Wen T.; Duh, Quan-Yang; Suh, Insoo
- Abstract
<bold>Background: </bold>Minimally invasive and remote access thyroid surgery has been evolving with the transoral endoscopic thyroidectomy vestibular approach (TOETVA) emerging as a true "scarless" thyroidectomy. In this study, we describe a hybrid transoral and submental thyroidectomy (TOaST) technique for thyroid lobectomy.<bold>Materials and Methods: </bold>A TOaST right thyroid lobectomy was performed for a 4 cm cytologically benign right thyroid nodule. Initial incision was made in the submental region with two additional 5 mm lateral ports inserted transorally. Right thyroid lobectomy proceeded via standard TOETVA with intact specimen extraction via the submental incision.<bold>Results: </bold>The patient was discharged home on postoperative day 1. Final pathology showed a 4.2 cm follicular adenoma. Cosmetic results and patient satisfaction were excellent.<bold>Discussion: </bold>This is the first reported case of a hybrid TOaST technique. It aims to maintain the principles and advantages of TOETVA while addressing its limitations related to large tumor extraction, mental nerve injury, and chin sensory changes. The shorter distance of dissection required may reduce postoperative pain. This approach may expand the indications for transoral thyroidectomy while maintaining excellent cosmetic outcomes.
- Subjects
THYROIDECTOMY; THYROID gland surgery; ENDOSCOPIC surgery; SUBMENTAL triangle; PLASTIC surgery; ENDOSCOPY; HUMAN dissection; THYROID gland tumors; VETERINARY dissection
- Publication
Journal of Laparoendoscopic & Advanced Surgical Techniques, 2018, Vol 28, Issue 11, p1374
- ISSN
1092-6429
- Publication type
journal article
- DOI
10.1089/lap.2018.0146