title: Retro-auricular video-assisted "gasless" thyroidectomy: feasibility study in human cadavers.
abstract: BACKGROUND
  In recent years, there has been a surge of interest in developing alternative surgical approaches to the thyroid gland with a focus on cosmesis. Approaches can be either complete endoscopic approaches using CO(2) insufflation or endoscopy-assisted approaches. We describe a novel approach for thyroidectomy via a retro-auricular incision without gas insufflation using endoscopic assistance.
  
  
  METHODS
  Six fresh human cadavers were utilized. Four head and neck specimens were used to assess the retro-auricular approach and the creation of surgical space in the lower neck. Three hemithyroidectomy in two fresh human cadavers procedures were performed via a retro-auricular approach. The end-point of the study was successful removal of the hemithyroid gland with preservation of the recurrent laryngeal nerve.
  
  
  RESULTS
  In all cases, the retro-auricular flap and subplatysmal plane could be achieved without difficulty. Three hemithyroid specimens were successfully removed in two cadaveric specimens using the retro-auricular approach with endoscopic guidance. Thyroid gland resection with identification and preservation of the recurrent laryngeal nerve could be achieved in all three procedures (100%).
  
  
  CONCLUSIONS
  The retro-auricular approach or the "Walvekar approach" permits adequate working space and an excellent endoscopic surgical view for removal of the ipsilateral hemithyroid gland with an option for a bilateral approach using a "gasless technique."
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, LSU Health Sciences Center, 533 Bolivar St, Suite 566, New Orleans, LA 70112, USA. rwalve@lsuhsc.edu
authors.forename: Rohan R
authors.initials: RR
authors.lastname: Walvekar
authors.forename: Eric
authors.initials: E
authors.lastname: Wallace
authors.forename: Beau
authors.initials: B
authors.lastname: Bergeron
authors.forename: Richard
authors.initials: R
authors.lastname: Whitworth
authors.forename: D David
authors.initials: DD
authors.lastname: Beahm
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Nuss
mesh_terms: D002102:Cadaver; D004724:Endoscopy; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D013965:Thyroidectomy / Q000379:methods*; D020535:Video-Assisted Surgery