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.