Our Summary

This research paper discusses a new technique for performing thyroid surgeries that leave no visible scar. The method is called transoral endoscopic thyroidectomy vestibular approach (TOETVA) and involves making an incision inside the mouth, rather than on the neck. The researchers tested this procedure in Germany and Austria and found it to be feasible and safe.

To improve this method and make it applicable for larger thyroid glands, the researchers combined it with another technique called retroauricular endoscopic cephalic access thyroid surgery (EndoCATS), a type of facelift surgery. This combination, referred to as TOVARA, allows for the removal of the thyroid gland without damaging the surrounding tissue and can be used for thyroid glands that are larger than usual.

The study involved 70 patients, with a median operation time of 205 minutes. Only two patients experienced long-term nerve injury, and there were no cases of infection. The researchers did not have to revert to traditional thyroid surgery at any point.

In conclusion, the researchers suggest that this new, scarless thyroid surgery technique is a promising advancement in the field and is both safe and feasible in Western Europe.

FAQs

  1. What is the transoral endoscopic thyroidectomy vestibular approach (TOETVA)?
  2. What is the combination of TOETVA and EndoCATS referred to as, and when is it used?
  3. Based on the research, what were the results and potential complications of using the TOVARA method for thyroid surgery?

Doctor’s Tip

A doctor may advise a patient undergoing thyroglossal duct cyst removal to inquire about the possibility of using the transoral endoscopic thyroidectomy vestibular approach (TOETVA) or the TOVARA technique to minimize scarring and reduce the risk of complications. It is important for the patient to discuss all available options with their healthcare provider to determine the best course of treatment for their specific case.

Suitable For

Patients who may be recommended for thyroglossal duct cyst removal include those who have symptoms such as difficulty swallowing or breathing, a visible lump in the neck, recurrent infections in the cyst, or if the cyst is causing cosmetic concerns. Additionally, patients who have a thyroglossal duct cyst that is growing in size or causing pain may also be recommended for removal. It is important for patients to consult with their healthcare provider to determine if thyroglossal duct cyst removal is the appropriate treatment option for their specific case.

Timeline

Before thyroglossal duct cyst removal:

  1. Patient experiences symptoms such as a painless lump in the neck, difficulty swallowing, and a feeling of pressure in the throat.
  2. Patient undergoes diagnostic tests such as ultrasound, CT scan, or MRI to confirm the presence of a thyroglossal duct cyst.
  3. Patient consults with a surgeon to discuss treatment options and risks associated with the surgery.
  4. Patient undergoes pre-operative preparations such as fasting and medication adjustments.

After thyroglossal duct cyst removal:

  1. Patient undergoes the surgery, which typically takes about 1-2 hours under general anesthesia.
  2. Patient may experience pain, swelling, and difficulty swallowing in the days following the surgery.
  3. Patient is discharged from the hospital within a day or two and given instructions on wound care and pain management.
  4. Patient follows up with the surgeon for post-operative appointments to monitor healing and recovery.
  5. Patient may experience a scar at the site of the incision, which will gradually fade over time.
  6. Patient’s symptoms such as difficulty swallowing and pressure in the throat should improve following the removal of the cyst.

What to Ask Your Doctor

Some questions a patient should ask their doctor about thyroglossal duct cyst removal include:

  1. What are the potential risks and complications associated with the surgery?
  2. How long is the recovery period, and what can I expect in terms of pain and discomfort?
  3. Will there be any visible scarring after the surgery?
  4. What is the success rate of this procedure in terms of completely removing the cyst?
  5. Are there any alternative treatment options available for my condition?
  6. How experienced are you in performing this type of surgery?
  7. Will I need to follow any special post-operative care instructions?
  8. What is the likelihood of the cyst recurring after removal?
  9. Are there any long-term effects or implications of having this surgery?
  10. Can you explain the TOETVA and TOVARA techniques and why you believe they are appropriate for my case?

Reference

Authors: Karakas E, Klein G, Schopf S. Journal: J Endocrinol Invest. 2020 May;43(5):615-622. doi: 10.1007/s40618-019-01149-9. Epub 2020 Jan 28. PMID: 31989449