Cosmetic Inframandibular Hyoid-Level Incision, Ligatureless Thyroidectomy with Neck Lift: an Original Technique

Excerpt

Most of our patients present late with large goitres that are not suitable for endoscopic thyroidectomy. The neck usually has 3 skin creases on the anterior aspect. The first and highest skin crease is at the level of the hyoid cartilage. The second is at the level of the cricoid cartilage. The classical Kocher’s incision is in the lowest skin crease and the scar is often visible as our people do not cover their neck due to hot weather. It is also prone to keloid formation. The scar of an incision in the second neck skin crease often straddles the thyroid cartilage prominence and is thus visible. Hence, an alternate high neck incision at the level of the hyoid was tried as this is a flexural area and is in the shadow of the face and chin and not seen. Addition of neck lift provides better cosmetic results than endoscopic thyroidectomy and surgery through incisions in second or third neck skin crease incisions. Radical neck dissection is difficult through this incision; hence, apron or hemi-apron incision is preferred by the author. This approach is not suitable for extended resection or if sternotomy is required. In patients with previous thyroid surgery, the old surgical scar is used. …