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Quantitative comparison of three thyroidectomy approaches in neck muscles, voice, and swallowing functions

Authors :
Shi-Lin Li
Pei Du
Tian Lv
Dong-ning Lu
Cheng-ying Shao
Yi-ning Zhang
Ru He
Wen-Shun Liu
Jia-Feng Wang
Wei-Li Ren
Ju-yong Liang
Jia-Jie Xu
Ming-Hua Ge
Source :
Asian Journal of Surgery, Vol 47, Iss 4, Pp 1734-1739 (2024)
Publication Year :
2024
Publisher :
Elsevier, 2024.

Abstract

Objective: This study compares endoscopic thyroidectomy by gasless unilateral axillary approach (ETGUA) and sternocleidomastoid leading-edge approach (SLEA) with conventional open thyroidectomy (COT) in hemithyroidectomy. The main focus is on the protection of neck muscles (sternocleidomastoid, omohyoid, sternothyroid) and the postoperative function of voice and swallowing yielded through these common approaches. Methods: A total of 302 patients who underwent hemithyroidectomy were enrolled and divided into three groups: ETGUA (n = 101), SLEA (n = 100), and COT (n = 101). Ultrasound was used to measure the thickness of bilateral neck muscles, including the sternocleidomastoid, omohyoid, and sternothyroid. The changes in thickness on the surgical side compared to the non-surgical side. Analyzed factors included muscle thickness changes, Swallowing Impairment Score (SIS), Voice Handicap Index (VHI), Scar Cosmesis Assessment and Rating (SCAR), Neck Injury Index (NII), surgery duration, drainage volume, hospitalization, and number of lymph nodes. Results: The clinical characteristics among the three groups were consistent except for differences in sex, age, and BMI. Metrics such as sternocleidomastoid muscle, NII, hypocalcemia, postoperative PTH, transient hoarseness, and number of lymph nodes showed no significant differences among the three groups. However, significant differences were found in the duration of surgery, drainage volume, hospitalization period omohyoid muscle, Sternohyoid muscle, VHI, SIS, and SCAR (all p

Details

Language :
English
ISSN :
10159584
Volume :
47
Issue :
4
Database :
Directory of Open Access Journals
Journal :
Asian Journal of Surgery
Publication Type :
Academic Journal
Accession number :
edsdoj.2a632667bc754b0f88ea6e37d6757183
Document Type :
article
Full Text :
https://doi.org/10.1016/j.asjsur.2023.12.085