• Lena W Chen, Christopher R Razavi, Hanna Hong, Akeweh Fondong, Rohit Ranganath, Surya Khatri, Wojciech K Mydlarz, Aarti Mathur, Masaru Ishii, Jason Nellis, Mohammad Shaear, Ralph P Tufano, and Jonathon O Russell.
• Division of Head and Neck Endocrine Surgery, Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
• Head Neck. 2020 Nov 1; 42 (11): 3336-3344.

BackgroundCentral neck scars following thyroidectomy can negatively impact patient quality of life. Transoral endoscopic thyroidectomy can reduce postoperative cosmetic burden.MethodsProspective cohort study of patients seen between June 2018 and January 2019. Scar cosmesis was determined using the validated Scar Cosmesis Assessment and Rating (SCAR) scale and a Visual Analog Scale (VAS) measuring color, contour, and irregularity.ResultsEighty-one patients (80% female, mean age 43.7 years) were analyzed, with 60% and 40% receiving transcervical and transoral thyroidectomy. Median time from surgery was 3.4 (range: 1-37.1) weeks. Mean SCAR score was greater for transcervical recipients (4.69 vs transoral 0.99, P < .001), indicating worse cosmesis. Mean surgeon-rated total VAS score was similarly increased for transcervical recipients (72.84 vs transoral 16.73, P < .001). Interrater reliability for both SCAR and total VAS scores was excellent (intraclass correlation 0.93; 95% CI: 0.90-0.95 for both).ConclusionTransoral thyroidectomy provides significantly enhanced early cosmesis over the transcervical approach.© 2020 Wiley Periodicals LLC.

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