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Cadaver Study on Transoral Thyroid Chondrolaryngoplasty and Transoral Sistrunk Operation, Possibility from Transoral Thyroidectomy

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Abstract

Objective

Transoral approaches in surgery are gaining global popularity. Transoral endoscopic and robotic thyroidectomies are well established due to the benefit of being truly scarless. Thyroid chondrolaryngoplasty reduces protrusion of the thyroid notch in transgender patients. The Sistrunk operation involves removal of the thyroglossal cyst and the central portion of the hyoid bone. In this cadaveric study, we developed a transoral thyroidectomy approach and assessed the feasibility of applying this technique to thyroid chondrolaryngoplasty and Sistrunk operation with the proper usage of a special endoscopic burr.

Methods

We performed surgery using the transoral vestibular approach with 13 fresh-frozen human cadavers. Unlike transoral thyroid surgery, which requires high-resolution detailed anatomical view, this technique uses a 5-mm 30-degree endoscope with a 5-mm central port. A smaller central port can reduce the risk of mental nerve paresthesia. A special endoscopic burr for functional endoscopic sinus surgery is used to thin the thyroid notch cartilage and cut the central portion of the hyoid bone.

Results

We successfully performed transoral thyroid chondrolaryngoplasty and transoral Sistrunk operation in 13 cadavers.

Conclusion

Transoral chondrolaryngoplasty and transoral Sistrunk operation are feasible for transgender or thyroglossal cyst patients. It offers the additional benefit of being a scarless surgery and could play a promising role in minimally invasive thyroid surgeries. Proper use of an endoscopic drilling burr to thin thyroid notch cartilage and cutting the central portion of the hyoid bone can make transoral thyroid chondrolaryngoplasty and transoral Sistrunk operation safe and feasible .

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Head & Neck Surgery, The Chinese University of Hong Kong, Sha Tin, Hong Kong

    Hok Nam Li & Michael Chi Fai Tong

  2. Department of Surgery, Yan Chai Hospital, Tsuen Wan, Hong Kong

    Peter Wing Hong Chan

Authors
  1. Hok Nam Li
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  2. Peter Wing Hong Chan
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  3. Michael Chi Fai Tong
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Correspondence to Hok Nam Li.

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There is no financial disclosure or conflict of interest.

Ethical approval

This study was approved by The Joint Chinese University of Hong Kong—New Territories East Cluster Clinical Research Ethics Committee.

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Li, H.N., Chan, P.W.H. & Tong, M.C.F. Cadaver Study on Transoral Thyroid Chondrolaryngoplasty and Transoral Sistrunk Operation, Possibility from Transoral Thyroidectomy. World J Surg 47, 2474–2478 (2023). https://doi.org/10.1007/s00268-023-07091-5

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  • DOI: https://doi.org/10.1007/s00268-023-07091-5

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