Ahamed P and Sabreen N*
Department of Cardiothoracic and Vascular Surgery, Sakra World Hospital, IndiaFulltext PDF
Thyroidectomies have been performed conventionally with Kocher?s incision over several years. With the advent of newer techniques thyroid procedures have been relatively safer and lower in complication rates. Though the current light is not alone on surgical technique but the aesthetic outcomes of the procedure itself. The preponderance of female patients undergoing thyroid surgeries where cosmesis is of great importance has influenced the development of extracervical approaches. Inferior cosmesis of thyroid scar on low anterior neck has been a concern for most young female patients following a classical Kocher?s incision. Hence various approaches have been explored since then to achieve good aesthetic results. Newer techniques like extracervical approaches, a variation of endoscopic thyroidectomies have been desired for improved cosmesis. Robotic thyroidectomy through transaxillary approach, post auricular and transoral routes for thyroid have evaded the scar visibility. These procedures are superior in aesthetics but often require elaborate instrumentation with extensive training in handling the same. And unavailability of the same in all centers are amongst the few disadvantages. In such instances a novel approach of first skin crease incision for thyroidectomy instead of caudad placed conventional Kocher?s incision for improved aesthetics can be used. The first skin crease follows the path of resting skin tension lines and often hides in the shadow of mandible obscuring the scar visibility. This incision is superior in cosmesis compared to conventional one but also economically achieved and evades the need for extensive subcutaneous dissection through remote sites.
Neck crease incision; Kocher?s incision; Aesthetics in thyroidectomies
Ahamed P, Sabreen N. A Contemporary Thinking on Thyroid Surgeries for Superior Cosmesis. Clin Surg. 2020; 5: 2970.