Pain and surgical outcomes with and without neck extension in standard open thyroidectomy: a prospective randomized trial.

BACKGROUND The purpose of this study was to compare surgical outcomes between those patients who underwent open thyroidectomy with and without neck extension. METHODS One hundred eighty patients were randomized into 2 groups, with neck extension (group I) and without neck extension (group II). Outcomes included pain score on postoperative day 0, day 1, and the first clinic visit, operating time, blood loss, recurrent laryngeal nerve (RLN) injury, and hypoparathyroidism. RESULTS Pain scores in group II were significantly lower on postoperative day 1 (2.38 vs 3.08; p = .022) and at the first clinic visit (0.57 vs 0.78; p = .026). There was a significant direct correlation between degree of neck extension and pain score on day 1 (p = .159 and p = .033). Other outcomes seemed comparable. However, the overall RLN injury rate was not significantly different between the 2 groups (5.3% vs 2.0%; p = .212). CONCLUSION Compared to group I, pain on postoperative day 1 and at the first visit in group II were significantly less, but both groups had similar overall RLN injury rate.