Transection of Sternocleidomastoid for Selective Neck Dissection in Recurrent Papillary Thyroid Cancers

The surgical treatment of papillary thyroid carcinoma is the most frequent procedure in endocrine oncologic practice for endocrine surgeons. With the advent of positron emission tomography scan, many of these patients who had previous surgery in the form of total thyroidectomy with neck dissection present with recurrent nodal metastasis which is the cause of thyroglobulin increase. Reoperative surgery is fraught with increased incidence of complications mainly the internal jugular vein injury and nerve injuries. In this scenario, good exposure helps in avoiding these injuries, and also helps the surgeon. We describe the exposure of the posterior triangle by the division of sternocleidomastoid superiorly off the mastoid tip and retracting the muscle downward and suturing it back at the end of the procedure.