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The clinical application of mental nerve dissection in transoral endoscopic thyroidectomy via an oral vestibular approach

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Abstract

Background

Transoral endoscopic thyroidectomy vestibular approach is the natural orifice surgery to avoid surgical scars. However, mental nerve injury is a characteristic complication. Herein, we report the development of a novel method to dissect the mental nerve proactively during surgery to minimize the morbidity from mental nerve injury.

Methods

In this study, a total of 105 patients from June 2016 to February 2018 were categorized as the mental nerve dissection group (MND) or not mental nerve dissection group (NMND). We analyzed the demographics, operative data, hospital stay, pathologic results, and postoperative complications between the two groups.

Results

There were no significant differences with respect to age, gender, tumor size, extent of surgery, the amount of bleeding, or postoperative hospitalization between groups. The specimen removal time was shorter in the MND group. The average operation time in both groups was similar, but the operation time for a hemithyroidectomy with CND in the MND group was shorter than in the NMND group. The VAS pain scores and complication rates that included transient hypocalcemia, seroma, subcutaneous emphysema, transient, and permanent recurrent laryngeal nerve palsy did not differ significantly between groups. In terms of mental nerve injury, the morbidity rate in the MND group was lower than in the NMND group.

Conclusions

The modified endoscopic thyroidectomy involving dissection of the mental nerve via the oral vestibular approach is safe and feasible. It is beneficial to protect the mental nerve and for specimen removal which is worth clinical promotion.

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Acknowledgements

This study was supported by Cancer Research Program of the National Cancer Center (Grant No. NCC2017A15).

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Author notes

  1. Xiaowei Peng and Zan Li are joint first authors.

Authors and Affiliations

  1. The Department of Head and Neck Surgery, Hunan Cancer Hospital, The Affiliated Tumor Hospital of Xiangya Medical School, Central South University, Changsha, Hunan, China

    Xiaowei Peng, Zan Li, Hui Li, Wen Peng, Xiao Zhou, Dajiang Song, Bo Zhou & Chunliu Lv

  2. Hunan Cancer Hospital, Changsha, Hunan, China

    Xiaowei Peng

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  1. Xiaowei Peng
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  2. Zan Li
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  3. Hui Li
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Correspondence to Xiaowei Peng.

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Disclosures

Xiaowei Peng, Zan Li, Hui Li, Wen Peng, Xiao Zhou, Dajiang Song, Bo Zhou and Chunliu Lv have no conflicts of interest or financial ties to disclose.

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Peng, X., Li, Z., Li, H. et al. The clinical application of mental nerve dissection in transoral endoscopic thyroidectomy via an oral vestibular approach. Surg Endosc 34, 153–158 (2020). https://doi.org/10.1007/s00464-019-06743-9

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  • DOI: https://doi.org/10.1007/s00464-019-06743-9

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