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The clinical application of mental nerve dissection in transoral endoscopic thyroidectomy via an oral vestibular approach

  • Xiaowei PengEmail author
  • Zan Li
  • Hui Li
  • Wen Peng
  • Xiao Zhou
  • Dajiang Song
  • Bo Zhou
  • Chunliu Lv
Article

Abstract

Background

Transoral endoscopic thyroidectomy vestibular approach is the natural orifice surgery to avoid surgical scars. However, mental nerve injury is a characteristic complication. Herein, we report the development of a novel method to dissect the mental nerve proactively during surgery to minimize the morbidity from mental nerve injury.

Methods

In this study, a total of 105 patients from June 2016 to February 2018 were categorized as the mental nerve dissection group (MND) or not mental nerve dissection group (NMND). We analyzed the demographics, operative data, hospital stay, pathologic results, and postoperative complications between the two groups.

Results

There were no significant differences with respect to age, gender, tumor size, extent of surgery, the amount of bleeding, or postoperative hospitalization between groups. The specimen removal time was shorter in the MND group. The average operation time in both groups was similar, but the operation time for a hemithyroidectomy with CND in the MND group was shorter than in the NMND group. The VAS pain scores and complication rates that included transient hypocalcemia, seroma, subcutaneous emphysema, transient, and permanent recurrent laryngeal nerve palsy did not differ significantly between groups. In terms of mental nerve injury, the morbidity rate in the MND group was lower than in the NMND group.

Conclusions

The modified endoscopic thyroidectomy involving dissection of the mental nerve via the oral vestibular approach is safe and feasible. It is beneficial to protect the mental nerve and for specimen removal which is worth clinical promotion.

Keyword

Transoral thyroidectomy Thyroid Endoscopic NOTES Mental nerve 

Notes

Acknowledgements

This study was supported by Cancer Research Program of the National Cancer Center (Grant No. NCC2017A15).

Compliance with ethical standards

Disclosures

Xiaowei Peng, Zan Li, Hui Li, Wen Peng, Xiao Zhou, Dajiang Song, Bo Zhou and Chunliu Lv have no conflicts of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.The Department of Head and Neck Surgery, Hunan Cancer Hospital, The Affiliated Tumor Hospital of Xiangya Medical SchoolCentral South UniversityChangshaChina
  2. 2.Hunan Cancer HospitalChangshaChina

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