Skip to main content
Log in

Postauricular and Axillary Approach Endoscopic Neck Surgery: A New Technique

  • Published:
World Journal of Surgery Aims and scope Submit manuscript



While the bilateral axillo-breast approach (BABA) to endoscopic neck surgery resolves various benign and malignant thyroid and parathyroid diseases with minimal adverse effects and excellent cosmetic outcomes, it involves circumareolar incisions. Many patients, especially young female patients, are reluctant to have their breast involved. Consequently, we developed the postauricular and axillary approach (PAA) that uses postauricular incisions.


From June 2006 to December 2007, we treated 10 patients with PAA endoscopic neck surgery. After subcutaneous infiltration with diluted epinephrine solution, the subplatysmal and subcutaneous spaces were dissected. Two axillary ports and two postauricular ports were used and low-pressure CO2 insufflation generated operative space. After dividing the midline between the strap muscles, the isthmus was divided and the thyroid lobe was dissected with ultrasonic shears and excised after careful identification of the recurrent laryngeal nerve and parathyroid glands. Malignant lesions were treated with contralateral thyroid lobectomy. For parathyroid adenomas, we performed parathyroidectomy after dividing the strap muscles in the midline.


Two thyroid lobectomies, one parathyroidectomy, one subtotal thyroidectomy, and six total thyroidectomies were performed by PAA endoscopic neck surgery. The mean operation time was 210.0 ± 43.7 min. There were no cases of conversion to open surgery, permanent vocal cord palsy, or facial nerve palsy. None of the thyroidectomy patients exhibited hypocalcemia. The cosmetic outcomes were excellent and all patients were satisfied.


PAA endoscopic neck surgery is a feasible method for thyroid and parathyroid surgery that permits good operative visualization and has minimal adverse effects and excellent cosmetic outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others


  1. Choe JH, Kim SW, Chung KW et al (2007) Endoscopic thyroidectomy using a new bilateral axillo-breast approach. World J Surg 31:601–606

    Article  PubMed  Google Scholar 

  2. Chung YS, Choe JH, Kang KH et al (2007) Endoscopic thyroidectomy for thyroid malignancies: comparison with conventional open thyroidectomy. World J Surg 31:2302–2306

    Article  PubMed  Google Scholar 

  3. Park JG (2005) Korea central cancer registry cancer incidence in Korea 1999–2001. Minister of Health & Welfare, Republic of Korea, p 40

    Google Scholar 

  4. Gagner M (1996) Endoscopic subtotal parathyroidectomy in patients with primary hyperparathyroidism. Br J Surg 83:875

    Article  PubMed  CAS  Google Scholar 

  5. Huscher CS, Chiodini S, Napolitano C et al (1997) Endoscopic right thyroid lobectomy. Surg Endosc 11:877

    Article  PubMed  CAS  Google Scholar 

  6. Duh QY (2003) Minimally invasive endocrine surgery—standard of treatment or hype? Surgery 134:849–857

    Article  PubMed  Google Scholar 

  7. Yeung GHC (2002) Endoscopic thyroid surgery today: a diversity of surgical strategies. Thyroid 12:703–706

    Article  PubMed  Google Scholar 

  8. Ikeda Y, Takami H, Niimi M et al (2001) Endoscopic thyroidectomy by the axillary approach. Surg Endosc 15:1362–1364

    Article  PubMed  CAS  Google Scholar 

  9. Duncan TD, Rashid Q, Speights F et al (2007) Endoscopic transaxillary approach to the thyroid gland: our early experience. Surg Endosc 21:2166–2177

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Yeo-Kyu Youn.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lee, K.E., Kim, H.Y., Park, W.S. et al. Postauricular and Axillary Approach Endoscopic Neck Surgery: A New Technique. World J Surg 33, 767–772 (2009).

Download citation

  • Published:

  • Issue Date:

  • DOI: