Postauricular and axillary approach endoscopic neck surgery

A new technique

Kyu Eun Lee, Hoon Yub Kim, Won Seo Park, Jun Ho Choe, Mi Ra Kwon, Seung Keun Oh, Yeo Kyu Youn

Research output: Contribution to journalArticle

65 Citations (Scopus)

Abstract

Background: While the bilateral axillo-breast approach (BABA) to endoscopic neck surgery resolves various benign and malignant thyroid and parathyroid diseases with minimal adverse effects and excellent cosmetic outcomes, it involves circumareolar incisions. Many patients, especially young female patients, are reluctant to have their breast involved. Consequently, we developed the postauricular and axillary approach (PAA) that uses postauricular incisions. Methods: From June 2006 to December 2007, we treated 10 patients with PAA endoscopic neck surgery. After subcutaneous infiltration with diluted epinephrine solution, the subplatysmal and subcutaneous spaces were dissected. Two axillary ports and two postauricular ports were used and low-pressure CO2 insufflation generated operative space. After dividing the midline between the strap muscles, the isthmus was divided and the thyroid lobe was dissected with ultrasonic shears and excised after careful identification of the recurrent laryngeal nerve and parathyroid glands. Malignant lesions were treated with contralateral thyroid lobectomy. For parathyroid adenomas, we performed parathyroidectomy after dividing the strap muscles in the midline. Results: Two thyroid lobectomies, one parathyroidectomy, one subtotal thyroidectomy, and six total thyroidectomies were performed by PAA endoscopic neck surgery. The mean operation time was 210.0 ± 43.7 min. There were no cases of conversion to open surgery, permanent vocal cord palsy, or facial nerve palsy. None of the thyroidectomy patients exhibited hypocalcemia. The cosmetic outcomes were excellent and all patients were satisfied. Conclusions: PAA endoscopic neck surgery is a feasible method for thyroid and parathyroid surgery that permits good operative visualization and has minimal adverse effects and excellent cosmetic outcomes.

Original languageEnglish
Pages (from-to)767-772
Number of pages6
JournalWorld Journal of Surgery
Volume33
Issue number4
DOIs
Publication statusPublished - 2009 Apr 1
Externally publishedYes

Fingerprint

Neck
Thyroidectomy
Thyroid Gland
Cosmetics
Parathyroidectomy
Breast
Parathyroid Diseases
Conversion to Open Surgery
Recurrent Laryngeal Nerve
Vocal Cord Paralysis
Muscles
Parathyroid Neoplasms
Insufflation
Parathyroid Glands
Hypocalcemia
Facial Paralysis
Thyroid Diseases
Facial Nerve
Ultrasonics
Epinephrine

ASJC Scopus subject areas

  • Surgery

Cite this

Lee, K. E., Kim, H. Y., Park, W. S., Choe, J. H., Kwon, M. R., Oh, S. K., & Youn, Y. K. (2009). Postauricular and axillary approach endoscopic neck surgery: A new technique. World Journal of Surgery, 33(4), 767-772. https://doi.org/10.1007/s00268-009-9922-8

Postauricular and axillary approach endoscopic neck surgery : A new technique. / Lee, Kyu Eun; Kim, Hoon Yub; Park, Won Seo; Choe, Jun Ho; Kwon, Mi Ra; Oh, Seung Keun; Youn, Yeo Kyu.

In: World Journal of Surgery, Vol. 33, No. 4, 01.04.2009, p. 767-772.

Research output: Contribution to journalArticle

Lee, Kyu Eun ; Kim, Hoon Yub ; Park, Won Seo ; Choe, Jun Ho ; Kwon, Mi Ra ; Oh, Seung Keun ; Youn, Yeo Kyu. / Postauricular and axillary approach endoscopic neck surgery : A new technique. In: World Journal of Surgery. 2009 ; Vol. 33, No. 4. pp. 767-772.
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