Clinical outcomes of percutaneous versus peroral intraoperative neuromonitoring strategies in transoral endoscopic thyroidectomy vestibular approach: A retrospective analysis of 2,201 patients

Recurrent laryngeal nerve palsy remains a critical complication in transoral endoscopic thyroidectomy vestibular approach. While intraoperative neuromonitoring is employed, the optimal strategy for reducing vocal cord palsy remains a topic of debate.

No actionable change for audiologists — this is a surgical neuromonitoring study with no direct clinical implications for audiology or hearing care practice.

For ENT surgeons performing transoral thyroidectomy, the choice of neuromonitoring approach may influence recurrent laryngeal nerve palsy rates, but this finding sits outside the core audiology scope.

1. 01Retrospective analysis of 2,201 patients undergoing transoral endoscopic thyroidectomy vestibular approach (TOETVA).
2. 02Compared percutaneous vs. peroral intraoperative neuromonitoring (IONM) of the recurrent laryngeal nerve.
3. 03Primary outcome was recurrent laryngeal nerve palsy (voice-box nerve damage) post-surgery.
4. 04Published in the journal Surgery (2026).
5. 05Findings are relevant to surgical ENT teams, not audiologists or hearing specialists.

PMID

42475946

DOI

10.1016/j.surg.2026.110432.

Journal

Surgery

Publication type

research_article

Evidence level

4

Sample size

2,201

Population

Patients undergoing transoral endoscopic thyroidectomy vestibular approach (TOETVA)

Intervention

Peroral intraoperative neuromonitoring of the recurrent laryngeal nerve

Comparator

Percutaneous intraoperative neuromonitoring of the recurrent laryngeal nerve