Transoral endoscopic vestibular approach for thyroidectomy and parathyroidectomy - From promise to practice

Oded Cohen; Ralph P Tufano; AngKoon Anuwong; Ashok R Shaha; Kerry D Olsen; Mark Zafereo; Alessandra Rinaldo; Antti A Mäkitie; Iain J Nixon; Jonathon O Russell; Alfio Ferlito; Avi Khafif

doi:10.1016/j.amjoto.2021.103022

Transoral endoscopic vestibular approach for thyroidectomy and parathyroidectomy - From promise to practice

Am J Otolaryngol. 2021 Sep-Oct;42(5):103022. doi: 10.1016/j.amjoto.2021.103022. Epub 2021 Mar 31.

Authors

Affiliations

¹ A.R.M. Center of Otolaryngology Head and Neck Surgery, Assuta Medical Center, Tel Aviv, Israel. Electronic address: oded.cohen@yale.edu.
² Division of Head and Neck Endocrine Surgery, Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins, Baltimore, United States.
³ Department of Surgery, Minimally Invasive Endocrine and Surgery Division, Police General Hospital, Bangkok, Thailand.
⁴ Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, United States.
⁵ Department of Otorhinolaryngology, Mayo Clinic, Rochester, MN, United States.
⁶ Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
⁷ University of Udine School of Medicine, Udine, Italy.
⁸ Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and HUS Helsinki University Hospital, Helsinki, Finland.
⁹ Department of Otorhinolaryngology Head and Neck Surgery, Edinburgh Royal Infirmary, Edinburgh, UK.
¹⁰ Coordinator of the International Head and Neck Scientific Group, Padua, Italy.
¹¹ A.R.M. Center of Otolaryngology Head and Neck Surgery, Assuta Medical Center, Tel Aviv, Israel.

PMID: 33838355
DOI: 10.1016/j.amjoto.2021.103022

Abstract

Objectives: To describe the evolution and recent series on transoral endoscopic vestibular approach thyroidectomy and parathyroidectomy (TOET/PVA).

Data sources: PubMed, Google Scholar.

Review methods: Review of the available English literature.

Results: TOET/PVA may offer several advantages over other remote access thyroidectomy approaches and has been adopted by many centers worldwide with excellent success rates. Indications include benign disease and early thyroid cancer patients. Complication rate is comparable to the trans-cervical approach. The suggested framework has been validated in recent studies and its feasibility confirmed.

Conclusion: TOET/PVA has now been used to treat thousands of patients worldwide due to low cost, short learning curve and excellent cosmetic outcomes. Further studies will be necessary to demonstrate oncologic non-inferiority and also the true value that is added by the approach.

Keywords: Cancer; Endoscopy; Parathyroid; Thyroid; Transoral.

Publication types

Review

MeSH terms

Cicatrix / etiology
Cicatrix / prevention & control
Feasibility Studies
Humans
Learning Curve
Parathyroid Glands / surgery
Parathyroidectomy / adverse effects
Parathyroidectomy / education
Parathyroidectomy / methods*
Thyroid Neoplasms / surgery*
Thyroidectomy / adverse effects
Thyroidectomy / education
Thyroidectomy / methods*
Treatment Outcome