Approach Removes Thyroid Gland without Neck Scarring or Need for Special Equipment

A surgical approach developed by ENT surgeons at LSU Health New Orleans to perform thyroidectomies without scarring the neck appears to be just as successful as standard surgery. When originally used, the approach, which involves making an incision behind the ear instead of in the neck, took advantage of modern robotics and endoscopic technology. It was available to patients only at centers with this specialized equipment. A new study led by Rohan Walvekar, MD, Associate Professor of Otorhinolaryngology at LSU Health New Orleans School of Medicine, shows that the same approach can be employed using standard surgical equipment and techniques, making it much more widely available. The study was published online in the Indian Journal of Otolaryngology Head and Head & Neck Surgery January 16, 2017.

Thyroidectomy has been the gold standard procedure for surgical management of thyroid disorders. There has been a concentrated effort over the last two decades to provide alternative approaches to the thyroid gland to avoid the neck scar associated with thyroid surgery. These approaches have been possible due to the incorporation of robotic and endoscopic technology. However, while there continues to be a demand for what is termed “distant” access thyroid surgery, these procedures involve the use of specialized instrumentation and require specially trained surgeons – both of which are only available at select centers in the country. In addition, the use of robotic technology for thyroid surgery is not FDA approved for this indication.

Over an 18-month period, Walvekar examined the outcomes of 10 patients who underwent open retro-auricular thyroidectomy with a slightly modified incision from the original technique. The incision follows the principles of standard face-lift approach incision that optimizes incision placement – hidden in the hairline and a natural skin crease. There were no major complications, and all patients reported satisfaction with the results.

Co-authors include Drs. Jason Trahan, Laura Pelaez, Michael DiLeo, Daniel Nuss and Leslie S. Son, all of LSU Health New Orleans School of Medicine’s Department of Otorhinolaryngology.