Background: Central neck scars following thyroidectomy can negatively impact patient quality of life. Transoral endoscopic thyroidectomy can reduce postoperative cosmetic burden.
Methods: Prospective 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.
Results: Eighty-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).
Conclusion: Transoral thyroidectomy provides significantly enhanced early cosmesis over the transcervical approach.
Keywords: scar cosmesis; scarless; thyroidectomy; transcervical; transoral.
© 2020 Wiley Periodicals LLC.