Cosmetic outcomes following transoral versus transcervical thyroidectomy.

Authors :: Chen LW
Razavi CR
Hong H
Fondong A
Ranganath R
Khatri S
Mydlarz WK
Mathur A
Ishii M
Nellis J
Shaear M
Tufano RP
Russell JO
Source :: Head & neck [Head Neck] 2020 Nov; Vol. 42 (11), pp. 3336-3344. Date of Electronic Publication: 2020 Aug 06.
Publication Year :: 2020
Abstract: Background: Central neck scars following thyroidectomy can negatively impact patient quality of life. Transoral endoscopic thyroidectomy can reduce postoperative cosmetic burden.<br />Methods: Prospective cohort study of patients seen between June 2018 and January 2019. Scar cosmesis was determined using the validated Scar Cosmesis Assessment and Rating (SCAR) scale and a Visual Analog Scale (VAS) measuring color, contour, and irregularity.<br />Results: Eighty-one patients (80% female, mean age 43.7 years) were analyzed, with 60% and 40% receiving transcervical and transoral thyroidectomy. Median time from surgery was 3.4 (range: 1-37.1) weeks. Mean SCAR score was greater for transcervical recipients (4.69 vs transoral 0.99, P < .001), indicating worse cosmesis. Mean surgeon-rated total VAS score was similarly increased for transcervical recipients (72.84 vs transoral 16.73, P < .001). Interrater reliability for both SCAR and total VAS scores was excellent (intraclass correlation 0.93; 95% CI: 0.90-0.95 for both).<br />Conclusion: Transoral thyroidectomy provides significantly enhanced early cosmesis over the transcervical approach.<br /> (© 2020 Wiley Periodicals LLC.)