# Impact of a Virtual Three-Dimensional Thyroid Model on Patient Communication in Thyroid Surgery: A Randomized Controlled Trial

## TL;DR

A virtual 3D thyroid model improves patient understanding of thyroid surgery anatomy and risks compared to traditional drawings.

## Contribution

Demonstrates that virtual 3D models enhance patient comprehension and communication in thyroid surgery counseling.

## Key findings

- Patients using the 3D model showed significantly better understanding of the recurrent laryngeal nerve and lymph node dissection.
- Comprehension of postoperative complications like hoarseness and hypocalcemia improved with the 3D model.
- The 3D model was found to be a practical and cost-effective supplement to traditional counseling.

## Abstract

Clear preoperative communication is essential for patients undergoing thyroid surgery, but understanding thyroid anatomy and surgical risks can be difficult using verbal explanations or simple drawings alone. In this randomized study, we compared traditional drawing-based counseling with communication supported by a virtual three-dimensional (3D) thyroid model in patients with newly diagnosed thyroid cancer. We found that patients who used the 3D model had a better understanding of key anatomical structures, such as the recurrent laryngeal nerve and lymph node dissection extent, as well as the mechanisms underlying major postoperative complications, including hoarseness, hypocalcemia, and bleeding. These findings suggest that virtual 3D thyroid models can enhance patient comprehension and support shared decision-making. Incorporating 3D visualization into routine preoperative counseling may represent a simple and effective way to improve patient education in thyroid surgery.

Background: Effective preoperative patient counseling is essential to shared decision-making. In thyroid surgery, patient communication can be complicated by the complex anatomy and variable surgical approaches, which may not be fully conveyed through conventional verbal explanations or schematic drawings. Virtual three-dimensional (3D) thyroid models may provide an intuitive tool to enhance patient comprehension. Methods: We conducted a randomized controlled trial at Peking Union Medical College Hospital with 94 newly-diagnosed thyroid cancer patients scheduled for thyroidectomy. Participants were assigned to either the control group (n = 47), which received preoperative drawing-based counseling, or the intervention group (n = 47), which utilized a virtual 3D model for communication. The Thyroid Navigator app, developed by Kuma Hospital, was used to provide dynamic 3D representation of the thyroid gland, surrounding structures, and potential surgical procedures. After standardized preoperative consultations, patients were surveyed to assess their understanding in pertinent anatomy and postoperative complications. Results: Patients in the 3D model group demonstrated similar correct response rates in lesion localization (p = 0.536) or parathyroid gland recognition (p = 0.071), but significantly higher accuracy in identifying the recurrent laryngeal nerve and the extent of lymph node dissection compared with the control group (p < 0.05). Moreover, comprehension of the causes of major postoperative complications—including hoarseness (recurrent laryngeal nerve injury, p = 0.004), hypocalcemia (parathyroid gland impairment, p = 0.015), and bleeding (inadequate hemostasis, p = 0.008)—was significantly improved in the 3D model group. Conclusions: Use of a virtual 3D thyroid model significantly improves patient comprehension of thyroid anatomy, surgical procedures, and potential complications, thereby enhancing clinician–patient communication. Virtual 3D models represent a practical and cost-effective supplement to conventional counseling in thyroid surgery, offering clear benefits in patient education and shared decision-making.