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New technique for removing thyroid leaves small scar only inside the mouth

On the Medical Watch: A more cosmetically appealing way to remove the thyroid gland – and the only person who will see the scar is your dentist.

“Traditionally we make a transcervical incision which is about a 4-6 centimeter incision straight across the neck,” says Dr Raymon Grogan, a endocrine surgeon at the University of Chicago Medicine.

It’s the traditional approach that’s been used for at least a century. But the operation to remove the thyroid gland – due to cancer, nodules or dysfunction -- leaves its mark.

“The problem is the location of this incision, it’s a very visible incision it’s a very prominent incision,” Dr Grogan says.  “In addition to that there are patients who have scarring problems, people who get keloids, hypertrophic scars.”

Alternative techniques have been tested – approaches from the armpit, breast and behind the ear. But a hidden route, pioneered by a surgeon in Thailand to address the stigma of a neck scar,  starts in the mouth.

Working from the top down, Dr Grogan makes three small incisions in the crease between the gums and the lower lip to accommodate his laparoscopic instruments.

“Then we’re able to make a small tunnel that goes along the jawline in front of the jaw and underneath the muscle of the neck. Once we get under the muscle here we’re actually in the same space that we are in with the traditional approach,” he says.

What appears to be a painful route has turned out to be palatable for patients.

“What they tend to have is a little bit of bruising sensation along the jawline,” Dr Grogan says.  “And a little bit of irritation on the inside of lip, partly because there are sutures in there.”

Dr Grogan has performed four thyroidectomies through the mouth at the University of Chicago Medicine.  600 have been done in Asia.

 

More info at

Dr Grogan’s home page

U of C Science Life: Removing thyroid and parathyroid glands via the mouth prevents a visible scar