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Annals of Surgical Oncology

, Volume 20, Issue 12, pp 3869–3876 | Cite as

A New Subfascial Approach in Open Thyroidectomy: Efficacy for Postoperative Voice, Sensory, and Swallowing Symptoms. A Randomized Controlled Study

  • Seung Pil Jung
  • Sung Hoon Kim
  • Soo Youn Bae
  • Se Kyung Lee
  • Sangmin Kim
  • Min-Young Choi
  • Jiyoung Kim
  • Minkuk Kim
  • Won Ho Kil
  • Jun-Ho Choe
  • Jung-Han Kim
  • Seok Jin Nam
  • Jee Soo Kim
Endocrine Tumors

Abstract

Background

After open thyroidectomy, patients usually complain of voice, sensory, and swallowing symptoms. We approached the thyroid via the subfascial method to reduce these symptoms and compared postthyroidectomy symptoms with the conventional subplatysmal method.

Methods

Eighty-six patients undergoing thyroidectomy were recruited and randomized into either a conventional subplatysmal approach group (subplatysmal, 42 patients) group or a subanterior fascia of strap muscle approach group (subfascial, 44 patients). Voice symptoms were assessed using the Voice Handicap Index questionnaire and acoustic voice analysis. Sensory alterations were evaluated by the light touch and pain touch methods. Swallowing symptoms were assessed using the Swallowing Impairment Score (SIS) questionnaire, barium swallowing time, and hyoid bone movement range. Each variable was measured preoperatively, and at 2 weeks and 3 months after thyroidectomy.

Results

In both groups, the subjective symptoms of voice, sensation, and swallowing were significantly worsened at 2 weeks after operation, but improved 3 months after operation. Patients in the subplatysmal group had worse SIS scores than patients in the subfascial group (p = 0.016) and delayed barium swallowing time 2 weeks after operation (p = 0.008 compared to preoperative level). In the cohort over 50 years of age, SIS score did not recover to preoperative levels in the subplatysmal group 3 months after operation (p = 0.005 compared to preoperative level).

Conclusions

The subfascial approach may be an effective method for reducing postthyroidectomy swallowing symptoms based on swallowing impairment score, especially in patients over 50 years of age.

Keywords

Papillary Thyroid Carcinoma Preoperative Level Strap Muscle Voice Handicap Index Open Thyroidectomy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgment

Supported in part by Samsung Medical Center Clinical Research Development Program Grant CRS-110-36-2.

Conflict of interest

The authors declare no conflict of interest.

Supplementary material

10434_2013_3163_MOESM1_ESM.docx (44 kb)
Supplementary material 1 (DOCX 43 kb)

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Copyright information

© Society of Surgical Oncology 2013

Authors and Affiliations

  • Seung Pil Jung
    • 3
  • Sung Hoon Kim
    • 2
  • Soo Youn Bae
    • 1
  • Se Kyung Lee
    • 1
  • Sangmin Kim
    • 1
  • Min-Young Choi
    • 4
  • Jiyoung Kim
    • 1
  • Minkuk Kim
    • 1
  • Won Ho Kil
    • 1
  • Jun-Ho Choe
    • 1
  • Jung-Han Kim
    • 1
  • Seok Jin Nam
    • 1
  • Jee Soo Kim
    • 1
  1. 1.Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulKorea
  2. 2.The U Breast Surgery CenterBundang-guKorea
  3. 3.Division of Breast and Endocrine Surgery, Department of Surgery, Korea University HospitalKorea University College of MedicineSeoulKorea
  4. 4.Department of SurgeryHanyang University Guri HospitalGuriKorea

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