This approach accesses the thyroid through an incision inside the mouth. J Laparoendosc Adv Surg Tech A. Popular incisions included the Lahey incision (Figure 42-1, A), the MacFee incision (Figure 42-1, B), and eventually a hockey stick type of incision (Figure 42-1, C).8 This last approach developed with recognition of the dangers of a trifurcated incision in which the tips of the trifurcation were prone to ischemia and devitalization, sometimes putting the great vessels of the neck at risk. Thyroidectomy for substernal usually includes goiters with minimal extension in the thoracic cavity and those that are present in the mediastinum (the area surrounding the chest cavity ). qDH z(a;Lq#t When this happens, you can trim the edges or let the glue fall off on its own. Incisions in Thyroid and Parathyroid Surgery | Ento Key In these cases, the voice will often be better in the mornings and "tire" toward the end of the day. In any case, the surgical team must be ready for complications from massive goiter surgery, such as: Substernal goiter can be removed through a relatively straight forward collar incision in the lower neck. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. In about 5% of patients who have thyroid surgery, the parathyroid glands do not function properly immediately after thyroid surgery. There are a number of factors that affect suitability for this procedure. Huang Z, Qin H, Liao J, Meng L, Qin Y, Li B, et al. Robotic thyroid surgery using a gasless, transaxillary approach and the da Vinci S system: the operative outcomes of 338 consecutive patients. A P value < 0.05 was considered as statistically significant. As per the largest study done, the rate of sternotomy is less than 5%, the complication rates are acceptable, and the mortality is less than 1%. The skin and subcutaneous tissues were separated, and subplatysmal . The best way to identify the proper crease and overall location is with the patient sitting upright in the preoperative holding area rather than waiting until the patient is lying supine on an operating table (Figure 42-6). Mitchem JB, Gillanders WE. 2023 BioMed Central Ltd unless otherwise stated. Indications for removal of the gland include most types of thyroid cancer, large goiters causing compression of the airway, and Graves disease. In the absence of contraindications, substernal goiter should be treated with early surgery rather than having it run the risk of acute airway distress, especially in younger patients. Temporary or sometimes permanent hypoparathyroidism (low blood calcium levels). Kang SW, Jeong JJ, Yun JS, Sung TY, Lee SC, Lee YS, et al. While the conventional collar incision is widely used, endoscopic thyroidectomy is gradually becoming accepted for thyroid nodule patients with cosmetic needs [2,3,4]. Written informed consent for publication of their clinical details and clinical images was obtained from all patients. A first attempt was replacement of the central . PubMed Central Yan HC, Xiang C, Wang Y, Wang P. Scarless endoscopic thyroidectomy (SET) lateral neck dissection for papillary thyroid carcinoma through breast approach: 10 years of experience.
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