Low transverse incision for lateral neck dissection in patients with papillary thyroid cancer: improved cosmesis

Background: Various incisions and approaches have been developed for lateral neck dissection. The purpose of this study was to compare the surgical and cosmetic outcomes of a single low transverse incision with the hockey stick incision for lateral neck dissection (LND) in patients with papillary thyroid carcinoma (PTC). Methods: We retrospectively analyzed 97 patients with PTC who underwent therapeutic LND and total thyroidectomy by low transverse incision (62 patients) or hockey stick incision (35 patients). We compared the operative results, cosmetic outcomes, objective scar measurement, and sensory disturbance between the two groups. Results: The number of harvested and metastatic lymph nodes, Vancouver Scar Scale scores, and sensory change were not significantly different between the two groups. The mean number of harvested lymph nodes in level II was 9.82 vs. 9.63 (P = 0.885) (transverse incision vs. hockey stick incision, respectively) and in level V was 6.36 vs. 5.63 (P = 0.597). However, subjective satisfaction with the scar and neck contour was higher in the low transverse incision group compared with the hockey stick incision group. Scores for scar consciousness and sensory change were not significantly different between the two groups. Conclusions: A single low transverse incision may provide equivalent surgical outcomes and superior cosmetic outcomes compared with the hockey stick incision for LND in PTC.