Combination of Surgical Subcision and Intralesional Corticosteroid Injection As a Cost-Effective and Minimally Invasive Treatment for Postoperative Adhesive Thyroidectomy Scars

Abstract

BACKGROUND 

Postoperative adhesive symptoms (swallowing difficulty or pulling sensation during neck extension) are one of the major complications of thyroidectomy. Moreover, adhesive scars are often visible and cause cosmetic concerns.

OBJECTIVE 

To evaluate the efficacy and safety of combined treatment with surgical subcision and intralesional corticosteroid injection for postoperative adhesive thyroidectomy scars.

METHODS 

A retrospective analysis was performed of 16 Korean patients with postoperative adhesive thyroidectomy scars treated with three sessions of surgical subcision and intralesional corticosteroid injection.

RESULTS 

The Vancouver Scar Scale score decreased significantly after treatment (P < .001). Follow-up revealed that six of the 16 patients (37.5%) had clinical improvement of 51% to 75%, six (37.5%) had moderate clinical improvement of 26% to 50%, and three (18.8%) had improvement of 76% to 100%; one patient (6.3%) demonstrated minimal to no improvement. After three sessions of treatment, the mean clinical improvement grade was 2.68, which means moderate to marked improvement compared to before treatment. Post-treatment erythema was observed in most patients, and notable bruising after treatment observed in five patients resolved spontaneously within 7 days.

CONCLUSION 

Combined treatment with surgical subcision and intralesional corticosteroid injection is a cost-effective and minimally invasive treatment for postoperative adhesive thyroidectomy scars.