副鼻腔手術用内視鏡を用いた内視鏡下甲状腺手術 Endoscopic Thyroid Surgery Using an Optical Device for Sinus Surgery
Thyroid tumor is one of the most common diseases encountered by otolaryngologists and head and neck surgeons. Most patients are young and female and have good prognosis. Therefore, surgery for thyroid tumor needs cosmetic consideration. Various approaches have been proposed to minimize or avoid an undesirable scar on the neck. As a result of these studies, enodoscopic thyroid surgery has been introduced. We performed endoscopic thyroid surgery using an optical device for sinus surgery which is familiar and conveniently available to otolaryngologists. The main incision was made below the clavicle on the chest wall. A second incision was placed on the lateral neck for insertion of an endoscope. After dissecting the layer under the platysma, two segments of Kirschner wire were horizontally inserted, then lifted up to obtain a working space. Vessels were incised with an ultrasonically activated scalpel or vessel sealing system. Magnified endoscopic vision permitted easy identification of the reccurent nerve. Use of a short endoscope improved surgical manageability. This method of endoscopic thyroid surgery offers cosmetic advantages to otolaryngologists.
耳鼻咽喉科臨床 101(3), 227-231, 2008-03-01
The Society of Practical Otolaryngology