The choice of incision is important according to the localization of the injury; low cervical collar incision
will be appropriate for one-third proximal injuries of the trachea as in our patient.
98% of these mediastinal parathyroid adenomas are resectable through a neck collar incision
, whereas 2% require a different approach (9).
Fourteen patients had high cervical / subglottic stenosis and were operated by high anterior cervical collar incision
, while five had lower tracheal stenosis, and two had carinal lesions and were operated by right thoracotomy (Figure 3).
An ectopic parathyroidectomy was then performed with a traditional transcervical collar incision
. When the space between the ascending aorta and sternum, inferior to the left innominate vein, was exposed, an abnormal mass, just left to the confluence of bilateral innominate vein, was identified.
In conventional thyroidectomy incision should be almost exactly transverse, extending well on to the borders of the sternocleidomastoid muscles (Kocher's neck collar incision
), made about two fingers above the sternal notch.
Low collar incision
was performed and the subplatysmal flap was raised.
Surgical failure, conversion to a collar incision
, and GA procedures were explained to the patients.
In 1974, Stell and Cooney reported that they had reduced the fistula rate to 13% by adapting a surgical technique that involved a collar incision
, closure of the pharyngeal defect in a straight line, a separate skin incision for the tracheostoma, and efficient suction drainage.
A low collar incision
was made and carried down through the subcutaneous tissue and platysma muscle.
In 12 (75%) cases cervical collar incision
was adequate to remove the gland with substernal extension.
There are many approaches for parathyroidectomy including open and minimally-invasive techniques.6 In our centre, we perform parathyroidectomy through traditional open (collar incision