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. 2024 Aug;134(8):3862-3867.
doi: 10.1002/lary.31372. Epub 2024 Feb 27.

Aesthetic Perceptions Regarding a Thyroidectomy Scar and Transvestibular Approach in Brazil

Guilherme Reimann Agne  1 , Hugo Fontan Kohler  2 , Renan Bezerra Lira  2 , Marcelo Belli  1 , Gustavo Nunes Bento  1 , Acklei Viana  3 , Luiz Paulo Kowalski  2   4
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Aesthetic Perceptions Regarding a Thyroidectomy Scar and Transvestibular Approach in Brazil

Guilherme Reimann Agne et al. Laryngoscope. 2024 Aug.

Abstract

Objective: We investigated motivation levels across the general Brazilian population and subgroups and their willingness to spend for surgery without a cervical scar.

Methods: This random-sample survey was performed by a specialized third-party research institute. In this study, we created a hypothetical thyroidectomy scenario, and the transcervical and transoral endoscopic thyroidectomy vestibular approach (TOETVA) were used. The survey included sociocultural data and questions regarding participants' surgical preferences.

Results: Data were obtained from 1250 participants; 42.4% were of the opinion that a cervical scar affects social or professional life. Young and childless women were most likely to be affected (p <0.001). All respondents accepted the transoral approach to avoid cervical scarring. However, 30.7% and 31.9% of respondents maintained their preference for TOETVA despite understanding the risks of a hypothetical increase in complications and unfavorable oncological outcomes and 98.6% were of the opinion that this approach was likely associated with greater postoperative pain. Only 16.2% were unwilling to spend for TOETVA. The variable that most affected patients' willingness to spend was a salary greater than 10 Brazilian minimum wages (odds ratio 9.797, 95% confidence interval, p <0.005). Upper class respondents were 10 times more likely to spend for TOETVA than lower class patients.

Conclusion: This study highlights patients' interest in TOETVA. Cervical scar perception is affected by concerned about appearance, particularly in certain societal subgroups. Our study population showed significant motivation to undergo TOETVA, which was emphasized by their acceptance of the complication rate, poor postoperative outcomes, greater postoperative pain, and willingness to spend on surgery with an invisible scar.

Level of evidence: 4 Laryngoscope, 134:3862-3867, 2024.

Keywords: TOETVA; patient perception; scar; thyroidectomy; transoral thyroidectomy.

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