title: Robotic Thyroidectomy: Comparison of a Postauricular Facelift Approach with a Gasless Unilateral Axillary Approach.
abstract: Robotic thyroidectomy using remote access approaches has gained popularity with patients seeking to avoid neck scarring and enhanced cosmetic satisfaction. The aim of this study was to compare the efficacy and advantages of a postauricular facelift approach vs a gasless unilateral axillary (GUA) approach in robotic thyroidectomy.
  
  
  
  Case series with chart review.
  
  
  
  University tertiary care hospital.
  
  
  
  We retrospectively analyzed the data of 65 patients who underwent robotic thyroidectomy with or without central neck dissection using a GUA approach (45 patients) or a postauricular facelift approach (20 patients) between September 2013 and December 2014. We excluded patients who underwent simultaneous lateral neck dissection or completion thyroidectomy.
  
  
  
  Robotic procedures were completed without being converted to an open procedure in all patients. There were no significant differences in terms of patient and tumor characteristics, extent of thyroidectomy and central neck dissection, operative time, complications, and postoperative pain between the 2 approaches, except the higher female ratio in the GUA approach group (female ratio, 95.6% vs 75%, P = .042). Cosmetic satisfaction evaluated by a questionnaire was not significantly different between the 2 groups, and most patients of both groups (85.7%) were satisfied with postoperative cosmesis.
  
  
  
  Both GUA and postauricular facelift approaches are feasible, with no significant adverse events in patients, and result in excellent cosmesis. However, a GUA approach seems to be superior when performing total thyroidectomy using a unilateral incision based on the preliminary result.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, South Korea.
authors.forename: Eui Suk
authors.initials: ES
authors.lastname: Sung
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, South Korea.
authors.forename: Yong Bae
authors.initials: YB
authors.lastname: Ji
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, South Korea.
authors.forename: Chang Myeon
authors.initials: CM
authors.lastname: Song
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, South Korea.
authors.forename: Bo Ram
authors.initials: BR
authors.lastname: Yun
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, College of Medicine, Hanyang University, Seoul, South Korea.
authors.forename: Won Sang
authors.initials: WS
authors.lastname: Chung
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, South Korea kytae@hanyang.ac.kr.
authors.forename: Kyung
authors.initials: K
authors.lastname: Tae
mesh_terms: D000328:Adult; D004724:Endoscopy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D037981:Neck Dissection; D061646:Operative Time; D010149:Postoperative Pain; D017060:Patient Satisfaction; D011183:Postoperative Complications; D012189:Retrospective Studies; D015361:Rhytidoplasty / Q000379:methods*; D065287:Robotic Surgical Procedures; D013524:Surgical Flaps; D013964:Thyroid Neoplasms / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods*; D016896:Treatment Outcome
keywords: gasless unilateral axillary approach; postauricular facelift approach; robotic thyroidectomy; thyroid cancer