Innovative Behind-the-Ear Technique Avoids Neck Scarring After Thyroid Surgery

By refining a surgical approach for treating common thyroid disorders, researchers found a way to successfully perform surgery without leaving telltale scars near the patient’s throat.

The technique involves making an incision behind the ear — in what researchers call a retro-auricular procedure — instead of beneath the voice box, where thyroidectomy procedures traditionally occur.

Researchers from LSU Health New Orleans originally developed the behind-the-ear surgical approach in 2010, but the cutting-edge technique required robotic surgery and specialized equipment, making it impractical for many patients without access to a specialized surgical center.

But in the new study, appearing in the Indian Journal of Otolaryngology and Head & Neck Surgery, researchers from LSU Health New Orleans discovered that the retro-auricular procedure could be performed using standard surgical equipment.

“Our goal was to create an efficient, safe and cost-effective approach that used standard surgical techniques and skills – making the approach reproducible and attractive to well-trained thyroid surgeons who may not have access to specialized equipment,” said Dr. Rohan Walvekar, associate professor of Otorhinolaryngology at LSU Health New Orleans School of Medicine.

The researchers tested the behind-the-ear approach on 10 patients, using standard surgical equipment. After tracking the patients for 18 months following surgery, they found zero complications and reported that all patients were satisfied with the results.

Taking Cues from Cosmetic Procedures

As a surgical procedure, a thyroidectomy is intended to remove all or parts of the thyroid gland and is common among patients with thyroid cancer, an overactive thyroid and other thyroid-related conditions.

During traditional thyroidectomy procedures, a surgeon makes a three- to four-inch incision along the patient’s neck and uses stitches to close up the incision following the procedure. Because the incision is in a visible part of the body, it often results in scarring that could take up to a year to mature.

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However, the new approach takes the cosmetic issue into question. “The incision follows the principles of standard face-lift approach incision that optimizes incision placement – hidden in the hairline and a natural skin crease,” describes an LSU Health release about the study.

Walvekar attributes the success of the new approach, which may allow many more individuals to take advantage of the retro-auricular procedure, to years of persistent research and innovation.

“We were the first to describe the feasibility of distant access to the thyroid using an incision behind the ear – our work was published in 2010 in Surgical Endoscopy,” noted Walvekar. “Since then, we have modified our technique to create an opportunity for distant access to the thyroid via an incision behind the ear (retro auricular).”

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“This approach is a cost-effective option for patients seeking distant access thyroid surgery in an environment where healthcare resources and access to advanced technology are limited,” added Walvekar.

Thyroid complications are most likely to affect women and those over 60, according to the National Institutes of Health. Thyroid cancer affects roughly 56,000 people every year, with the majority of them being women, according to the American Cancer Society.