Lateral Approach for Thyroid : An Alternative for Thyroid Reoperations

Abstract

Introduction: Thyroidectomy is the most frequently performed endocrine surgery worldwide. However, redo thyroidectomies present significant challenges due to their higher risk of complications. The lateral approach to the thyroid offers a viable alternative to the conventional midline exploration. This technique focuses on carefully identifying the natural tissue plane between the strap muscles and the ipsilateral sternocleidomastoid muscle to access the thyroid bed. A study was conducted to evaluate the effectiveness, safety, and potential complications associated with lateral approach.

Material and Methods: A prospective observational study was conducted in the breast and endocrine division of Department of General Surgery in Sher-i-Kashmir Institute of medical sciences. Data was collected from January 2021 to February 2024. 30 patients were included in the study.

Results: A total of 30 patients were included in the study who underwent a lateral approach for thyroid reoperation. Data was collected from 28 patients as two patients were lost to follow up. 23 (82.1 %) were females and 5 (17.8%) were males. Age ranged between 21 and 55 with median age of 33.42 years. All 28 patients were admitted for completion thyroidectomy and had previous history of hemithyroidectomy. 20 (71.4%) patients had a diagnosis of papillary thyroid cancer and 8 (28.6%) had a diagnosis of follicular thyroid carcinoma. 3 (10.7%) patients developed Transient hypocalcemia and permanent hypocalcemia was not seen in any patient. 2 (6.3 %) patients had hoarseness of voice post operatively which was transient and voice improved within 3 months. Hematoma was not seen in any of the patients.

Conclusion: The lateral approach to the thyroid is a reliable and safe alternative to the conventional method for reexplorative thyroid surgery.