Surgery
A standard transverse 4 to 6 cm mid-cervial skin incision was made for all patients usually 1 cm below the cricoid cartilage. The care is taken to place the incision in one of the skin creases of the neck. The subplatysmal superior flap is elevated to just above the notch of the thyroid cartilage. The subplatysmal inferior flap was dissected inferiorly to the level of the sternal notch. Retractors were used to provide and maintain exposure. First, superior pole of the thyroid lobe is ligated and disconnected. Second, recurrent laryngeal nerves (RLN) and parathyroid glands were carefully dissected. Finally inferior lobe is dissected and inferior thyroid vessels were ligated. Same procedures were applied for the opposite lobe, if planned. During closure strap muscles and subcutaneous tissue was approximated with 4-0 absorble Vicryl sutures and skin was closed with 4-0 non-absorble polyprolene(PP) sutures in a subcuticuler continous fashion. Single passive drain was used in all patients and placed through the incision line.