Ko How-Yun, Lu I-Cheng, Chang Pi-Ying, Wang Ling-Feng, Wu Che-Wei, Yu Wing-Hei Viola, Hwang Tzer Zen, Wang Chien Chung, Huang Tzu-Yen, Chiang Feng-Yu
Department of Otolaryngology-Head and Neck Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Gland Surg. 2020 Apr;9(2):372-379. doi: 10.21037/gs.2020.02.20.
Open thyroidectomy via conventional midline approach can be challenging in complex thyroid surgeries. This study proposes a U-shaped strap muscle flap (USMF) technique that provides adequately wide exposure of the surgical field.
Strap muscles were cut close to the clavicle and along the anterior margin of both sternocleidomastoid muscles followed by total thyroidectomy in 20 patients as USMF group, and surgical outcomes were compared with 40 patients who had received total thyroidectomy via midline approach.
No patient had postoperative hematoma, vocal cord paralysis, permanent hypocalcaemia, wound infection or flap necrosis. At 2 months post-surgery, objective voice analysis and subjective assessment of voice and swallowing showed no significant difference between groups.
USMF provides superb surgical field exposure, and the voice and swallowing functions after USMF are comparable to those obtained by midline approach. The USMF approach is a feasible option for selective difficult thyroid surgery.
在复杂的甲状腺手术中，经传统中线入路进行开放性甲状腺切除术可能具有挑战性。本研究提出一种U形带状肌瓣（USMF）技术，该技术可提供足够宽阔的手术视野暴露。
在20例患者中，将带状肌靠近锁骨并沿双侧胸锁乳突肌前缘切断，随后行全甲状腺切除术，作为USMF组，并将手术结果与40例经中线入路行全甲状腺切除术的患者进行比较。
无患者出现术后血肿、声带麻痹、永久性低钙血症、伤口感染或皮瓣坏死。术后2个月，客观语音分析以及语音和吞咽的主观评估显示两组之间无显著差异。
USMF可提供极佳的手术视野暴露，且USMF术后的语音和吞咽功能与中线入路相当。USMF入路是选择性困难甲状腺手术的一种可行选择。
