Lymph node metastasis is common in differentiated thyroid cancer especially papillary thyroid cancer.Presence of lymph node metastasis does not have an impact on survival in younger patients.Therapeutic central and la...Lymph node metastasis is common in differentiated thyroid cancer especially papillary thyroid cancer.Presence of lymph node metastasis does not have an impact on survival in younger patients.Therapeutic central and lateral neck dissection in the presence of clinically or radiologically evident lymph nodes has resulted in good overall survival.However,disease persistence in the lymph node/early recurrences may be seen in patients owing to lymph nodes that may be missed during the initial neck dissection.These observed locations are retropharyngeal and parapharyngeal nodal location,retro carotid location,sublingual,axillary,and intraparotid locations,supraclavicular and superficial to the sternothyroid muscle.We aim to highlight these locations with the goal to minimize persistence or early recurrence of disease at these locations.展开更多
Transoral Endoscopic Thyroidectomy Vestibular Approach(TOETVA)is a recently described surgical technique where the thyroid and central neck can be accessed without a cutaneous incision.To date nearly 700 cases have be...Transoral Endoscopic Thyroidectomy Vestibular Approach(TOETVA)is a recently described surgical technique where the thyroid and central neck can be accessed without a cutaneous incision.To date nearly 700 cases have been described within the English literature demonstrating the feasibility,safety,and efficacy of the technique.As more institutions begin to adopt the surgical approach,it is important that surgeons pay close attention to appropriate patient selection and surgical optimization to prevent experience-related complications.A valuable tool to facilitate these considerations is the utilization of surgeon-performed ultrasonography(US).While the merits of surgeon-performed US are well-documented within head&neck endocrine surgery as a whole,its value may be of even greater importance when implementing a novel surgical technique such as TOETVA.Here we highlight and summarize the role of surgeon-performed US within head&neck endocrine surgery,focusing on how it may influence patient selection and surgical planning with TOETVA.展开更多
Advances in imaging for preoperative localization have propelled the widespread adoption of minimally invasive/focused parathyroidectomy in primary hyperparathyroidism.Though it is performed through a relatively small...Advances in imaging for preoperative localization have propelled the widespread adoption of minimally invasive/focused parathyroidectomy in primary hyperparathyroidism.Though it is performed through a relatively small incision,studies have shown that the presence of a neck scar increases attentional bias towards the neck resulting in compromised quality of life.Transoral endoscopic parathyroidectomy vestibular approach(TOEPVA)eliminates a neck scar.While indications for TOEPVA are the same as that of minimally invasive open parathyroidectomy,confident preoperative localization of the parathyroid with a surgeon performed ultrasound along with concordant localization with SPECT CT is an essential prerequisite before offering patients this approach for parathyroidectomy.Early data has demonstrated the feasibility and safety of this approach.展开更多
Thyroid and parathyroid surgery continues to evolve all over the globe.This came as a result of an improvement in imaging techniques and accessibility to healthcare.The vast majority of these procedures is performed b...Thyroid and parathyroid surgery continues to evolve all over the globe.This came as a result of an improvement in imaging techniques and accessibility to healthcare.The vast majority of these procedures is performed by the hands of low volume surgeons,and subsequently leads to more frequent complications compared to high-volume surgeons especially when dealing with oncological conditions that mandate management of neck lymph nodes.展开更多
文摘Lymph node metastasis is common in differentiated thyroid cancer especially papillary thyroid cancer.Presence of lymph node metastasis does not have an impact on survival in younger patients.Therapeutic central and lateral neck dissection in the presence of clinically or radiologically evident lymph nodes has resulted in good overall survival.However,disease persistence in the lymph node/early recurrences may be seen in patients owing to lymph nodes that may be missed during the initial neck dissection.These observed locations are retropharyngeal and parapharyngeal nodal location,retro carotid location,sublingual,axillary,and intraparotid locations,supraclavicular and superficial to the sternothyroid muscle.We aim to highlight these locations with the goal to minimize persistence or early recurrence of disease at these locations.
文摘Transoral Endoscopic Thyroidectomy Vestibular Approach(TOETVA)is a recently described surgical technique where the thyroid and central neck can be accessed without a cutaneous incision.To date nearly 700 cases have been described within the English literature demonstrating the feasibility,safety,and efficacy of the technique.As more institutions begin to adopt the surgical approach,it is important that surgeons pay close attention to appropriate patient selection and surgical optimization to prevent experience-related complications.A valuable tool to facilitate these considerations is the utilization of surgeon-performed ultrasonography(US).While the merits of surgeon-performed US are well-documented within head&neck endocrine surgery as a whole,its value may be of even greater importance when implementing a novel surgical technique such as TOETVA.Here we highlight and summarize the role of surgeon-performed US within head&neck endocrine surgery,focusing on how it may influence patient selection and surgical planning with TOETVA.
文摘Advances in imaging for preoperative localization have propelled the widespread adoption of minimally invasive/focused parathyroidectomy in primary hyperparathyroidism.Though it is performed through a relatively small incision,studies have shown that the presence of a neck scar increases attentional bias towards the neck resulting in compromised quality of life.Transoral endoscopic parathyroidectomy vestibular approach(TOEPVA)eliminates a neck scar.While indications for TOEPVA are the same as that of minimally invasive open parathyroidectomy,confident preoperative localization of the parathyroid with a surgeon performed ultrasound along with concordant localization with SPECT CT is an essential prerequisite before offering patients this approach for parathyroidectomy.Early data has demonstrated the feasibility and safety of this approach.
文摘Thyroid and parathyroid surgery continues to evolve all over the globe.This came as a result of an improvement in imaging techniques and accessibility to healthcare.The vast majority of these procedures is performed by the hands of low volume surgeons,and subsequently leads to more frequent complications compared to high-volume surgeons especially when dealing with oncological conditions that mandate management of neck lymph nodes.
