ArticleJournal of endocrinological investigation2020
Transoral thyroid surgery vestibular approach: does size matter anymore?
Article in Journal of endocrinological investigation, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.
- Complications of Trans-oral Endoscopic Thyroidectomy Vestibular Approach: A Systematic Review.In vivo (Athens, Greece)Pooled it
- Surgical efficiency, safety, and quality of life among four various approaches for T1 stage papillary thyroid carcinoma: a prospective cohort study.Surgical endoscopy · 2026Observational
- Preliminary experience with the transoral endoscopic thyroidectomy vestibular approach in selected complex cases: a case series and literature review.Frontiers in surgery · 2026Article
- [Indications and technique for transoral thyroid gland and parathyroid gland surgery].Chirurgie (Heidelberg, Germany) · 2024Review
- Complication and conversion outcomes in transoral endoscopic thyroidectomy vestibular approach (TOETVA): a retrospective multicenter propensity score-matched cohort study.Updates in surgery · 2024Article
- First case report of benign subcutaneous thyroid tissue implantation following transoral endoscopic thyroidectomy vestibular approach (TOETVA).AME case reports · 2024Article
- Unveiling the Accuracy of Ultrasonographic Assessment of Thyroid Volume: A Comparative Analysis of Ultrasonographic Measurements and Specimen Volumes.Journal of clinical medicine · 2023Article
- Transoral Thyroidectomy: Initial Results of the European TOETVA Study Group.World journal of surgery · 2023Article
- Transoral thyroid surgery vestibular approach.Innovative surgical sciences · 2022Article
- Multimodal Assessments of Altered Sensation after Transoral Endoscopic Thyroidectomy.World journal of surgery · 2022Article
- Transoral thyroid surgery vestibular approach: is there an increased risk of surgical site infections?Updates in surgery · 2022Article
- Endoscopic cephalic access thyroid surgery (EndoCATS) using the retroauricular approach - a single centre retrospective data analysis.Surgical endoscopy · 2022Article
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Authors and funding
3 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundVarious approaches for endoscopic and minimally invasive thyroid operations have been reported, with some becoming popular to date. The aim of these procedures is to reduce and prevent visible scars in the neck. This led to the transoral endoscopic thyroidectomy vestibular approach (TOETVA) technique applicable in small thyroid specimen. To amend TOETVA and to broaden the indication for transoral thyroid surgery, our aim was to combine the TOETVA with the retroauricular endoscopic cephalic access thyroid surgery (EndoCATS) facelift approach.
methodsAfter successful implementation of the TOETVA technique in 2017, we evaluated the transoral technique regarding feasibility and safety in well-selected patients in Germany and Austria. With the combination of TOETVA and EndoCATS, we were able to optimize the extraction process of the specimen by avoiding damage to the thyroid capsule and to broaden the indication of transoral surgery by operating on thyroid glands with higher volume. Patients' characteristics, surgical outcome and complications were determined.
resultsSeventy-one transoral procedures were performed in 70 patients. The TOETVA procedure was performed in 60 patients, and 10 female patients underwent TOVARA with transoral thyroid lobe mobilization and removal of the specimen via the retroauricular access. Overall, median operation time was 205 min (range 96-370 min) and permanent RLNP rate was 1% accordant to 99 nerves at risk (39 hemithyroidectomies, 29 total thyroidectomies, 2 parathyroid resections, and 1 thyroglossal cyst resection). No conversion to conventional open surgery was necessary. Long-term mental nerve injury occurred in two patients. No infection was identified.
conclusionsTransoral thyroid and parathyroid surgery via the vestibular approach is both feasible and safe in Western Europe. The combination of the TOETVA with the retroauricular endoscopic cephalic access thyroid surgery (EndoCATS) facelift approach, called TOVARA, is a promising opportunity to allow for thyroid surgery without a visible scar in specimen with volume of more than 40 ml also.
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