He Ping, Nguyen Van Cuong, Lee Jin Won, Song Chang Myeon, Ji Yong Bae, Tae Kyung
Department of Otolaryngology, Huadong Hospital, Fudan University, Shanghai, China.
Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea.
Eur Arch Otorhinolaryngol. 2025 Sep;282(9):4835-4845. doi: 10.1007/s00405-025-09536-0. Epub 2025 Jul 4.
This study aimed to evaluate the long-term follow-up results of skin sensation alterations at the chin and lower lip in transoral robotic thyroidectomy (TORT).
We prospectively assessed the cutaneous sensation of the face and neck in 128 patients who underwent TORT using the Semmes-Weinstein monofilament test, preoperatively and postoperatively at one week, one month, three months, one year, and two years serially. Using a numerical rating scale, we also evaluated the patient's subjective symptom score of skin sensory disturbance at the chin and lower lip.
The mean pressure threshold did not differ pre- and postoperatively in the chin and lower lip innervated by the mental nerve, except in the left side of those one week postoperatively. Seventeen (15.3%) patients at the chin and 8 (7.2%) patients at the lower lip presented with an increased pressure threshold one week after surgery. The mean subjective sensory loss scores at the chin and lower lip increased significantly after surgery and remained until two years after surgery. However, there were no correlations between subjective sensory loss and pressure threshold scores.
TORT can be performed without permanent sensory loss at the lower lip and chin if the procedure is performed correctly with proper vestibular incisions.
本研究旨在评估经口机器人甲状腺切除术(TORT)后下巴和下唇皮肤感觉改变的长期随访结果。
我们前瞻性地评估了128例行TORT患者面部和颈部的皮肤感觉,术前及术后1周、1个月、3个月、1年和2年连续使用Semmes-Weinstein单丝试验进行评估。我们还使用数字评分量表评估了患者下巴和下唇皮肤感觉障碍的主观症状评分。
颏神经支配的下巴和下唇术前术后平均压力阈值无差异,但术后1周左侧除外。17例(15.3%)下巴患者和8例(7.2%)下唇患者术后1周压力阈值升高。术后下巴和下唇的平均主观感觉丧失评分显著增加,并一直持续到术后两年。然而,主观感觉丧失与压力阈值评分之间没有相关性。
如果手术操作正确且前庭切口合适,TORT术后下唇和下巴不会出现永久性感觉丧失。