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Liu Z, Li Z, Peng X, Zhou B, Lv C, Yi L, Li H, Peng W, Wang Z, Li J. Transoral endoscopic thyroidectomy vestibular approach in a patient with Class III goitre (operative steps and video). Gland Surg 2020; 9:1605-1613. [PMID: 33224838 DOI: 10.21037/gs-20-147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Transoral endoscopic thyroidectomy vestibular approach (TOETVA) has recently become a hot research topic due to the advantage of leaving no scar, but, according to most centers, its indication is restricted to the size of thyroid gland. Here we report a case of a female patient with Class III goitre who successfully underwent TOETVA (video attached). A 53-year-old woman with a previous history of chest keloidosis presented with a history of neck swelling for 3 years and was diagnosed as Hashimoto's thyroiditis with no nodules. The patient insisted that she undergo a TOETVA procedure in our hospital. Compared to the traditional TOETVA, several techniques were applied in this operation to ensure the resection and removal of the thyroid gland: with the dissection of the mental nerve and using the lateral approach to the thyroid gland. The total volume of thyroid gland was 205 mL. The operating time was 195 min. No complications were incurred. The numbness of the lip and chin was measured by the "two-points discrimination" method with several aspects (touch, pain, temperature) at different times to evaluate mental nerve injury. She felt the numbness during the first operative day but it was almost completely relieved in the third postoperative month. To our knowledge, this is the largest thyroid gland reported removed with TOETVA procedure. By carefully designing the operative steps, it is feasible to use the transoral approach in patients who have a benign thyroid disease with a Class III goitre if the patient strongly desires that operation.
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Affiliation(s)
- Zeyang Liu
- Department of Oncology Plastic Surgery/Head and Neck Surgery, Hunan Cancer Hospital/the Affiliated Cancer Hospital of Xiangya Medical School, Central South University, Changsha, China
| | - Zan Li
- Department of Oncology Plastic Surgery/Head and Neck Surgery, Hunan Cancer Hospital/the Affiliated Cancer Hospital of Xiangya Medical School, Central South University, Changsha, China
| | - Xiaowei Peng
- Department of Oncology Plastic Surgery/Head and Neck Surgery, Hunan Cancer Hospital/the Affiliated Cancer Hospital of Xiangya Medical School, Central South University, Changsha, China
| | - Bo Zhou
- Department of Oncology Plastic Surgery/Head and Neck Surgery, Hunan Cancer Hospital/the Affiliated Cancer Hospital of Xiangya Medical School, Central South University, Changsha, China
| | - Chunliu Lv
- Department of Oncology Plastic Surgery/Head and Neck Surgery, Hunan Cancer Hospital/the Affiliated Cancer Hospital of Xiangya Medical School, Central South University, Changsha, China
| | - Liang Yi
- Department of Oncology Plastic Surgery/Head and Neck Surgery, Hunan Cancer Hospital/the Affiliated Cancer Hospital of Xiangya Medical School, Central South University, Changsha, China
| | - Hui Li
- Department of Oncology Plastic Surgery/Head and Neck Surgery, Hunan Cancer Hospital/the Affiliated Cancer Hospital of Xiangya Medical School, Central South University, Changsha, China
| | - Wen Peng
- Department of Oncology Plastic Surgery/Head and Neck Surgery, Hunan Cancer Hospital/the Affiliated Cancer Hospital of Xiangya Medical School, Central South University, Changsha, China
| | - Zhiyuan Wang
- Department of Ultrasound, Hunan Cancer Hospital/the Affiliated Cancer Hospital of Xiangya Medical School, Central South University, Changsha, China
| | - Jigang Li
- Department of Pathology, Hunan Cancer Hospital/the Affiliated Cancer Hospital of Xiangya Medical School, Central South University, Changsha, China
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