title: Microscopic thyroidectomy: a prospective controlled trial.
abstract: The purpose of this prospective study was to evaluate microsurgical thyroidectomy by comparing it with traditional thyroidectomy. Before surgery, patients were assigned either to the microscopic thyroidectomy group (MT group), with the use of the surgical microscope, or the traditional thyroidectomy group (TT group), without the use of visual magnification. Outcome measures were operative time, intraoperative bleeding and complication rates including injury to the recurrent laryngeal nerve (RLN), the external branch of the superior laryngeal nerve (EBSLN) or the parathyroid glands. Ninety-eight patients underwent thyroid surgery (58 patients in the MT group, 40 patients in the TT group). The two groups were similar in age, sex, surgical procedures and histological findings. There was no difference between the two techniques regarding the operative time and the amount of blood loss. Neither permanent nerve palsy nor persistent hypocalcemia occurred in either group. Transient nerve palsies (RLN and EBSLN) were lower in the MT group (1.7%) compared to the TT group (7.5%), but the difference did not reach statistical significance (P>0.05). Overall transient hypocalcemia was significantly lower in the MT group (1.7%) compared with the TT group (12.5%, P=0.032). If the population was restricted to total thyroidectomy, the rate of transient hypocalcemia was 4.1% in the MT group and 33.3% in the TT group, respectively (P=0.022). In conclusion, microsurgical thyroidectomy is a feasible and efficacious surgical procedure. It significantly reduces the complications without increasing the operating time in thyroid surgery procedures. A major advantage of this technique is the possibility of attaching a camera to the microscope, thereby greatly facilitating teaching.
authors.affiliation: ENT Clinic, Sisli Etfal Training and Research Hospital, Istanbul, Turkey. hseven1@hotmail.com
authors.forename: Huseyin
authors.initials: H
authors.lastname: Seven
authors.forename: Asli Batur
authors.initials: AB
authors.lastname: Calis
authors.forename: Cetin
authors.initials: C
authors.lastname: Vural
authors.forename: Suat
authors.initials: S
authors.lastname: Turgut
mesh_terms: D000328:Adult; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008866:Microsurgery / Q000379:methods*; D011300:Preoperative Care; D011446:Prospective Studies; D013965:Thyroidectomy / Q000379:methods*; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000453:epidemiology / Q000209:etiology
references.citation: Am J Surg. 1992 Dec;164(6):634-9
references.pmid: 1463114
references.citation: Laryngoscope. 1995 Nov;105(11):1173-5
references.pmid: 7475870
references.citation: Arch Otolaryngol Head Neck Surg. 2002 Mar;128(3):296-303
references.pmid: 11886347
references.citation: Surgery. 1994 Feb;115(2):139-44
references.pmid: 8310401
references.citation: Eur Arch Otorhinolaryngol. 2001 Nov;258(9):460-2
references.pmid: 11769992
references.citation: Arch Otolaryngol Head Neck Surg. 1991 May;117(5):516-8
references.pmid: 2021469
references.citation: World J Surg. 1988 Aug;12(4):522-7
references.pmid: 3420935
references.citation: Surgery. 1987 Dec;102(6):999-1008
references.pmid: 3686359
references.citation: Surgery. 2001 Dec;130(6):1055-9
references.pmid: 11742338
references.citation: Arch Otolaryngol Head Neck Surg. 2001 Jan;127(1):61-5
references.pmid: 11177016
references.citation: Otolaryngol Head Neck Surg. 2001 Jan;124(1):111-4
references.pmid: 11228465
references.citation: Am J Otolaryngol. 1998 Mar-Apr;19(2):113-7
references.pmid: 9550443
references.citation: Am J Surg. 1975 Oct;130(4):399-404
references.pmid: 1166930
references.citation: Microsurgery. 1998;18(8):460-1
references.pmid: 9888350
references.citation: Laryngoscope. 2002 Jan;112(1):124-33
references.pmid: 11802050
references.citation: Arch Otolaryngol Head Neck Surg. 2002 Apr;128(4):389-92
references.pmid: 11926912
references.citation: J Laryngol Otol. 1998 Jun;112(6):556-60
references.pmid: 9764296
references.citation: Eur Arch Otorhinolaryngol. 2001 Nov;258(9):451-4
references.pmid: 11769989
references.citation: Arch Surg. 2000 Feb;135(2):204-7
references.pmid: 10668882