A paired comparison analysis of third-party rater thyroidectomy scar preference

Rajakumar, Chandrew; Doyle, Philip C.; Brandt, Michael G.; Moore, Corey C.; Nichols, Anthony C.; Franklin, Jason; Yoo, John; Fung, Kevin

doi:10.1017/s002221511600952x

Cited by 4 publications

(4 citation statements)

References 29 publications

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“… 28 Furthermore, a study exploring third party rater preference for thyroidectomy scar noted that raters preferred low, short scars; as opposed to, longer thyroidectomy scars. 29 Interestingly, a recent study utilized a discrete choice experiment to evaluate the influence of cosmetic concerns on patients’ decision-making processes when choosing among different thyroidectomy approaches. They similarly concluded that presence of a neck scar also influenced patient decision-making, but this was dependent on patient age with younger patients preferring a scarless approach.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Preference and Utility Measures for Transoral Thyroidectomy

Samargandy

Philteos

et al. 2022

Ann Otol Rhinol Laryngol

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Background: Traditional, trans-cervical thyroidectomy results in the presence of a neck scar, which has been shown to correlate with lower quality of life and lower patient satisfaction. Transoral thyroid surgery (TOTS) has been utilized as an alternative approach to avoid a cutaneous incision and scar by accessing the neck and thyroid through the oral cavity. This study was designed to evaluate patient preference through health-state utility scores for TOTS as compared to conventional trans-cervical thyroidectomy. Methods: In this cross-sectional study, patient preferences were elicited for TOTS and trans-cervical thyroidectomy with the use of an online survey. Respondents were asked to consider 4 hypothetical health scenarios involving thyroid surgery with varying approaches. Health-state utility scores were elicited using visual analog scale and standard gamble exercises. Results: Overall, 516 respondents completed the survey, of whom 261 (50.6%) were included for analysis, with a mean age of 41.5 years (SD 14.9 years), including 171 (65.5%) females. Health utility scores were similar for TOTS and conventional transcervical techniques. Statistically significant differences in the standard gamble utility score were noted for gender and ethnicity across all scenarios. Comparisons of visual analog score utilities were not statistically significant based on respondent demographics. Conclusion: Preferences for TOTS and trans-cervical thyroidectomy did not significantly differ in the current study. Females and white ethnicity indicated stronger preference for a TOTs approach compared to males and other ethnicities, respectively. Some literature suggests certain types of patients who might prefer minimally invasive thyroidectomy more so than other patients—in keeping with the current findings of this study.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Preference and Utility Measures for Transoral Thyroidectomy

Samargandy

Philteos

et al. 2022

Ann Otol Rhinol Laryngol

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“…Studies by Chaung et al and Rajakumar et al evaluated patient's perception on the length, thickness or neck position of the thyroid scar. 3,28 This current study adds value by evaluating the patient's perception when presented with a neck scar versus a hidden scar at the axilla or hairline. This gives a direct comparison between SET versus conventional open thyroid surgery.…”

Section: Discussionmentioning

confidence: 99%

“…In recent years, there is an increasing variety of approaches available to patients, including remote access and 'scarless' in-the-neck surgery to achieve a satisfactory scar appearance post-surgery. 1,3 Open thyroid surgery was first described by Billroth and Kocher in the 1800s and is still the most established approach for thyroidectomy. 4 Despite the good operative outcomes of open thyroid surgery, new approaches are constantly created to overcome the concern of a visible scar over the neck made by the conventional Kocher incision.…”

Section: Introductionmentioning

confidence: 99%

Preoperative scar perception study comparing ‘scarless’ in the neck endoscopic thyroidectomy with open thyroidectomy: a cross-sectional study

Qiu

Lau

Wong

et al. 2020

annals

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Introduction Open thyroidectomy is the most common approach to thyroid surgery. However, ‘scarless’ (in the neck) endoscopic thyroidectomy, consisting of endoscopic and robotic surgery, is progressively being adopted for its perceived cosmetic benefits. This study aims to determine the patient’s preferred surgical approach and to identify the factors that influence their decision. Materials and methods A pilot study consisting of 100 patients with a surgical thyroid disorder were prospectively recruited from a single tertiary centre. An interviewer-administered survey was conducted. Demographic, socioeconomic status, scar perception and an adapted body image scale were evaluated to identify factors that shaped the patient’s perception of the surgical approach. Results The mean age of participants was 54.5 ± 13.0 years; 72% were women and 87% Chinese. Of the 100 patients, 75 patients considered scarless endoscopic thyroidectomy as their preferred surgical approach while 25 patients opted for open thyroid surgery. Improvement in scar perception score between scarless endoscopic thyroidectomy and open thyroid surgery is associated with an increased willingness to choose scarless endoscopic thyroidectomy. The mean body image scale score was 6.9 ± 2.8, indicating no statistical difference between the surgical approaches. On multivariate analysis, improvement in scar perception score (odds ratio 3.38, 95% confidence interval 1.11–10.29) and having surgeon recommendation (odds ratio 6.38, 95% confidence interval 1.80–22.63) were independently associated with interest in scarless endoscopic thyroidectomy. Conclusion Patients interest in undergoing scarless endoscopic thyroidectomy is driven by improved scar perception and surgeon’s recommendation compared with open thyroid surgery.

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“…There are some different methods of evaluating the quality of the scars [6][7][8] . They tend to be complex but are more complete when taking into account the opinion of the patients, and when the observation is made by someone other than the surgeon who performed the operation, which is an evident bias.…”

Section: /6mentioning

confidence: 99%

Time heals. A study of thyroidectomy scars

Filho¹,

Araújo-Neto²,

Matos³

2021

Arch. Head Neck Surg.

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Introduction: Thyroidectomy is a commonly performed surgical procedure and there is a major concern among patients about the resultant scar in an exposed area of the body. Objective: To evaluate the quality of the thyroidectomy scars over a long period of time. Methods: Over a period of two years the quality of the thyroidectomy scars among 283 consecutive patients was registered during their follow-up for malignancies. On a scale of 0 (excellent) to 3 (bad) thyroidectomy scars were classified according to the time after surgery. Results: After 5 years or more 95% of the scars were classified as excellent or very good; 55% of them were excellent, which indicates that the scar was virtually invisible at a distance of 1.5 meters. Only 5% of the cases had a regular or bad scar after 5 years or more, and only one patient (0,5%) had a bad scar. Conclusion:The scars remaining after thyroid surgery had an improved appearance with time, and the vast majority of patients had an excellent or very good scar after a period of five years or more.

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A paired comparison analysis of third-party rater thyroidectomy scar preference

Cited by 4 publications

References 29 publications

Evaluation of Preference and Utility Measures for Transoral Thyroidectomy

Evaluation of Preference and Utility Measures for Transoral Thyroidectomy

Preoperative scar perception study comparing ‘scarless’ in the neck endoscopic thyroidectomy with open thyroidectomy: a cross-sectional study

Time heals. A study of thyroidectomy scars

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