Midcervical scar satisfaction in thyroidectomy patients

Best, Amy R.; Shipchandler, Taha Z.; Cordes, Susan R.

doi:10.1002/lary.26177

Cited by 66 publications

(48 citation statements)

References 20 publications

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“…Until now, we have not had a reliable way to measure how observers allocate attention to neck scars, which left us unable to make meaningful assessments about how to improve surgery outcomes. This research also correlates with both Western and Eastern data supporting the assertion that an incision in the central neck causes some patients to feel self‐conscious and seek subsequent intervention to minimize the impact of this incision …”

Section: Discussionsupporting

confidence: 74%

“…This research also correlates with both Western and Eastern data supporting the assertion that an incision in the central neck causes some patients to feel self-conscious and seek subsequent intervention to minimize the impact of this incision. 36 It is beyond the scope of this article to ascertain individual patient and observer factors that affect scar perceptions, but using eye tracking to objectively measure social attention of deformities such as neck scars can be helpful to more accurately define the characteristics of the deformity that render it worthy of attention and the point at which it does attract attention. This can help us direct our efforts; for example, observers gazed more on the neck in patients with thyroid neck scars, suggesting that avoidance of a central neck incision may be important in reducing this distraction.…”

Section: Discussionmentioning

confidence: 99%

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Objectively measuring social attention of thyroid neck scars and transoral surgery using eye tracking

Juárez¹,

Ishii

Nellis

et al. 2019

The Laryngoscope

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Objective Measure the social attention of thyroid neck scars and transoral surgery using eye tracking. Methods Observers viewed images of patients with thyroid neck scars, control patients with no scars, and patients who underwent transoral thyroidectomy as an eye‐tracking monitor recorded their eye movements. Hotelling's multivariate analysis, followed by planned posthypothesis testing, were used to compare fixation times for the central triangle (CT), peripheral face, and neck between the three groups. To assess if these gaze patterns would normalize with transoral surgery, a two‐sample t test was done to assess for differences in neck fixations between control and transoral patients and between transoral and traditional thyroidectomy. Results One hundred and thirty participants completed the eye‐tracking experiment (mean age 24.3 years, 65 females). Observers directed the majority of their attention to the CT in both control and scar patients. Observers paid more attention to the neck (103.72 ms, P < .0001, 95% confidence interval [CI] [55, 152] ms) and less to the peripheral face (115.50 ms, P = .01, 95% CI [19, 211] ms) in patients with neck scars than in control patients. Furthermore, transoral surgery eliminated this attentional distraction wherein there was no difference in the fixation time to the neck (−39.198 ms P = .16, 95% CI [−93.978, 15.5816] ms) between controls and those who underwent transoral surgery. Conclusion Observers directed their gaze away from the face and toward the neck in patients with thyroid neck scars. Furthermore, this distraction was eliminated with tranoral surgery. These findings shed light onto the altered observer perceptions of patients with thyroid neck scars. Level of Evidence NA Laryngoscope, 129:2789–2794, 2019

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Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Objectively measuring social attention of thyroid neck scars and transoral surgery using eye tracking

Juárez¹,

Ishii

Nellis

et al. 2019

The Laryngoscope

View full text Add to dashboard Cite

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“…Although it has been the standard approach for more than 100 years, it does leave a permanent cervical scar that may heal in a variable fashion. Some patients find this troubling and seek other options to minimize the scar …”

Section: Introductionmentioning

confidence: 99%

“…Some patients find this troubling and seek other options to minimize the scar. [2][3][4][5] Richmon et al in a cadaver, 6,7 demonstrated the feasibility of a transoral vestibular technique. It was brought to clinical practice in 2014 8 with the endoscopic approach and was reported to be safe and effective in a larger series of patients in 2016.…”

Section: Introductionmentioning

confidence: 99%

Transoral robotic thyroidectomy on two human cadavers using the Intuitive da Vinci single port robotic surgical system and CO₂ insufflation: Preclinical feasibility study

et al. 2019

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Background Transoral vestibular approach endoscopic thyroidectomy has gained popularity worldwide because it avoids a cutaneous incision. Some surgeons have expressed reservations about operating with only 2 instruments in the endoscopic technique, and some therefore utilize an axillary incision as an adjunct to facilitate dissection. The Intuitive da Vinci single port robotic system offers the potential to overcome this limitation without an axillary incision. Methods In this study, the Intuitive da Vinci single port robotic surgical system was used to perform transoral thyroidectomy on 2 human cadavers. Results A total thyroidectomy was performed in 2 cadavers using the da Vinci single port (SP) robot via transoral vestibular technique. The dissections were performed with removal of the thyroid gland and preservation of the recurrent laryngeal nerves and parathyroid glands. Conclusion In our evaluation, transoral vestibular approach robotic thyroidectomy using the Intuitive da Vinci SP system facilitated dissection without the need for an axillary incision.

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“…2 Despite these improvements, studies have demonstrated that there can be a significant negative impact on patient quality of life (QOL) as a result of a visible cervical scar. 3 Moreover, it is not only the severity or length of the scar but the mere presence of one that leads to this finding. 4 International communities, most notably in Asia, have made significant strides in remote access and minimally invasive thyroidectomy while demonstrating safety profiles similar to those through a traditional anterior cervical incision.…”

Section: Introductionmentioning

confidence: 99%

Anterior cervical incision‐sparing thyroidectomy: Comparing retroauricular and transoral approaches

Russell

Razavi

Khadem

et al. 2018

Laryngoscope Investig Oto

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ObjectivesThe robotic retroauricular approach and transoral endoscopic thyroidectomy vestibular approach (TOETVA) have been employed to avoid anterior neck scarring in thyroidectomy with good success. However, outcomes have yet to be compared between techniques. We compare our initial clinical experience with these approaches for thyroid lobectomy at our institution.MethodsA review of initial consecutive patients who underwent robotic facelift thyroidectomy (RFT) (August 2011–August 2016) at our institution was conducted. This was compared with the same number of initial consecutive patients who underwent TOETVA (September 2016–September 2017) at our institution. Demographics, operative time, pathology, complications, and learning curve were compared between cohorts. Learning curve was defined based on the slope of linear regression models of operative time versus case number.ResultsThere were 20 patients in each cohort. There was no statistically significant difference in demographic data between cohorts. One hundred percent of RFT cases versus 95% TOETVA cases (P = .999) were completed without conversion to standard open technique with median operative times of 201 (124–293) minutes versus 188 (89–343) minutes with RFT and TOETVA, respectively (P = .36). There was no incidence of permanent recurrent laryngeal nerve injury in either cohort. The slopes of the regression models were 0.29 versus −8.32 (P = .005) for RFT and TOETVA, respectively.ConclusionRFT and TOETVA are safe and feasible options for patients motivated to avoid an anterior neck scar. However, the quicker learning curve without the need for a costly robotic system may make TOETVA the preferred technique for institutions wishing to perform anterior cervical incision‐sparing thyroidectomy.Level of Evidence4

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Midcervical scar satisfaction in thyroidectomy patients

Abstract: 4 Laryngoscope, 127:1247-1252, 2017.

Cited by 66 publications

References 20 publications

Objectively measuring social attention of thyroid neck scars and transoral surgery using eye tracking

Objectively measuring social attention of thyroid neck scars and transoral surgery using eye tracking

Transoral robotic thyroidectomy on two human cadavers using the Intuitive da Vinci single port robotic surgical system and CO₂ insufflation: Preclinical feasibility study

Anterior cervical incision‐sparing thyroidectomy: Comparing retroauricular and transoral approaches

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Midcervical scar satisfaction in thyroidectomy patients

Abstract: 4 Laryngoscope, 127:1247-1252, 2017.

Cited by 66 publications

References 20 publications

Objectively measuring social attention of thyroid neck scars and transoral surgery using eye tracking

Objectively measuring social attention of thyroid neck scars and transoral surgery using eye tracking

Transoral robotic thyroidectomy on two human cadavers using the Intuitive da Vinci single port robotic surgical system and CO2 insufflation: Preclinical feasibility study

Anterior cervical incision‐sparing thyroidectomy: Comparing retroauricular and transoral approaches

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Product

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Transoral robotic thyroidectomy on two human cadavers using the Intuitive da Vinci single port robotic surgical system and CO₂ insufflation: Preclinical feasibility study