This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Related letters  • Similar articles in this journal  Topic Collections  • Endocrine Disease of Head & Neck  • Surgery  • Endocrine Surgery  • Endocrine Diseases  • Thyroid/ Parathyroid Diseases  • Alert me on articles by topic  Social Bookmarking   What's this?

A Paired Cohort Study

Daniel A. O’Connell, MD, MSc; Christopher Diamond, MD; Hadi Seikaly, MD, FRCSC; Jeffrey R. Harris, MD, FRCSC

Arch Otolaryngol Head Neck Surg. 2008;134(1):85-93.

Objective  To determine if performing parathyroidectomy surgery through minimal access (MA) incisions has any notable aesthetic or quality-of-life impact on patients compared with conventional access (CON) techniques.

Design  Paired cohort with (1) a prospective MA incision and scar cohort and (2) a sex- and age-matched (within 3 years) retrospective CON incision and scar cohort.

Setting  Tertiary care center.

Patients  Fifteen patients enrolled in prospective study protocol over a 2-year period; 11 patients met inclusion criteria. A sex- and age-matched retrospective cohort of patients was selected from a patient population undergoing surgical treatment of thyroid neoplastic diseases using a CON approach. Inclusion criteria were use of MA incision for parathyroidectomy and return for long-term follow-up scar assessment.

Interventions  Minimal access parathyroidectomy surgery vs CON thyroidectomy surgical procedures, postoperative follow-up assessment of scar aesthetics by patient and naive viewers, and digital photography and analysis of the surgical incision site. All patients were followed for at least 8 months after surgery.

Main Outcome Measures  The Patient and Observer Scar Assessment Scale (POSAS), Vancouver Scar Scale, and photographic scar analysis by naive viewers.

Results  There was no significant difference in scar assessment scale scores between the MA and CON cohorts and no clinically significant difference in overall patient satisfaction with scars between cohorts (POSAS: Patient Scar Assessment Scale, P = .14, and Observer Scar Assessment Scale, P = .79; Vancouver Scar Scale, P = .76). There was increased visibility of scars in the CON cohort to naive viewers.

Conclusions  Although they were more readily visible to naive viewers, CON (larger) cervical scars created in parathyroidectomy or thyroidectomy surgery do not translate into decreased patient satisfaction with their scar result. This may indicate a limited quality-of-life benefit in using MA approaches in transcervical surgical procedures.

Author Affiliations: Division of Otolaryngology–Head and Neck Surgery, University of Alberta, Edmonton, Alberta, Canada.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati     What's this?

RELATED LETTERS

Cosmesis in Thyroid and Parathyroid Surgery: A Matter of Perspective
David J. Terris and Melanie W. Seybt
Arch Otolaryngol Head Neck Surg. 2008;134(10):1120.
EXTRACT | FULL TEXT  

Cosmesis in Thyroid and Parathyroid Surgery: A Matter of Perspective—Reply
Jeffrey R. Harris, Daniel O’Connell, Christopher Diamond, and Hadi Seikaly
Arch Otolaryngol Head Neck Surg. 2008;134(10):1120-1121.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Cosmesis in Thyroid and Parathyroid Surgery: A Matter of Perspective
Terris and Seybt
Arch Otolaryngol Head Neck Surg 2008;134:1120-1120.
FULL TEXT  

Cosmesis in Thyroid and Parathyroid Surgery: A Matter of Perspective--Reply
Harris et al.
Arch Otolaryngol Head Neck Surg 2008;134:1120-1121.
FULL TEXT