BACKGROUND: In recent years, there has been a surge of interest in developing alternative surgical approaches to the thyroid gland with a focus on cosmesis. Approaches can be either complete endoscopic approaches using CO(2) insufflation or endoscopy-assisted approaches. We describe a novel approach for thyroidectomy via a retro-auricular incision without gas insufflation using endoscopic assistance. METHODS: Six fresh human cadavers were utilized. Four head and neck specimens were used to assess the retro-auricular approach and the creation of surgical space in the lower neck. Three hemithyroidectomy in two fresh human cadavers procedures were performed via a retro-auricular approach. The end-point of the study was successful removal of the hemithyroid gland with preservation of the recurrent laryngeal nerve. RESULTS: In all cases, the retro-auricular flap and subplatysmal plane could be achieved without difficulty. Three hemithyroid specimens were successfully removed in two cadaveric specimens using the retro-auricular approach with endoscopic guidance. Thyroid gland resection with identification and preservation of the recurrent laryngeal nerve could be achieved in all three procedures (100%). CONCLUSION: The retro-auricular approach or the "Walvekar approach" permits adequate working space and an excellent endoscopic surgical view for removal of the ipsilateral hemithyroid gland with an option for a bilateral approach using a "gasless technique."
BACKGROUND: In recent years, there has been a surge of interest in developing alternative surgical approaches to the thyroid gland with a focus on cosmesis. Approaches can be either complete endoscopic approaches using CO(2) insufflation or endoscopy-assisted approaches. We describe a novel approach for thyroidectomy via a retro-auricular incision without gas insufflation using endoscopic assistance. METHODS: Six fresh human cadavers were utilized. Four head and neck specimens were used to assess the retro-auricular approach and the creation of surgical space in the lower neck. Three hemithyroidectomy in two fresh human cadavers procedures were performed via a retro-auricular approach. The end-point of the study was successful removal of the hemithyroid gland with preservation of the recurrent laryngeal nerve. RESULTS: In all cases, the retro-auricular flap and subplatysmal plane could be achieved without difficulty. Three hemithyroid specimens were successfully removed in two cadaveric specimens using the retro-auricular approach with endoscopic guidance. Thyroid gland resection with identification and preservation of the recurrent laryngeal nerve could be achieved in all three procedures (100%). CONCLUSION: The retro-auricular approach or the "Walvekar approach" permits adequate working space and an excellent endoscopic surgical view for removal of the ipsilateral hemithyroid gland with an option for a bilateral approach using a "gasless technique."
Authors: Sang-Wook Kang; Jong Ju Jeong; Kee-Hyun Nam; Hang Seok Chang; Woong Youn Chung; Cheong Soo Park Journal: J Am Coll Surg Date: 2009-06-12 Impact factor: 6.113
Authors: Hans Martin Schardey; Stefan Schopf; Michael Kammal; Mirco Barone; Wolfgang Rudert; Thomas Hernandez-Richter; Stefan Pörtl Journal: Surg Endosc Date: 2008-02-23 Impact factor: 4.584
Authors: Jason Trahan; Laura Pelaez; Michael DiLeo; Daniel W Nuss; Leslie S Son; Rohan R Walvekar Journal: Indian J Otolaryngol Head Neck Surg Date: 2017-01-16
Authors: Thomas von Ahnen; Ulrich Wirth; Martin von Ahnen; Julia Kroenke; Peter Busch; Hans-Martin Schardey; Stefan Schopf Journal: Surg Endosc Date: 2021-01-11 Impact factor: 4.584