Am J Otolaryngol Head Neck Surg | Volume 8, Issue 1 | Surgical Technique | Open Access
Mahbub Alam, Dewan Mahmud Hasan, Gifarie Tayeef Islam, Mohosana Khanam, Tanvir Hussain and Abdul Matin
Departmentof Otolaryngology, Shaheed Suhrawardy Medical college Hospital, Bangladesh
Department of Otolaryngology, Bangladesh Specialist Hospital, Dhaka, Bangladesh
Department of Otolaryngology, Head and Neck Surgery, Limerick University Hospital, Ireland
*Correspondance to: Abdul Matin
Fulltext PDFBackground: Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA) is emerging as a safe minimal surgical intervention for thyroidectomy to avoid visible scars in the neck, first reported by Angkoon Anuwong in 2015. The goal of this study is to evaluate the safety and efficacy of TOETVA in a Bangladeshi population for the first time. Methods: This retrospective cross-sectional study was conducted at the Department of Otolaryngology and Head-Neck Surgery, Shaheed Suhrawardy Medical College Hospital, Dhaka, from July 2022 to December 2024. Eighty patients with benign thyroid nodules <4 cm, papillary thyroid carcinoma <2 cm, or follicular lesions ≤4 cm were included. TOETVA was performed under general anaesthesia with a three-port technique through the oral vestibule, and thyroidectomy was done endoscopically using conventional laparoscopic instruments. Demographic data and surgical variables including operative time, blood loss, and complications were analyzed. Results: The study population was predominantly female (90%) with an age range of 14–55 years and a mean age of 28.6 years. TOETVA was performed for benign nodules/Thy II in 82.5% of cases, and for indeterminate and malignant nodules in 17.5% of cases. Out of 80 cases, 2 required conversion to open procedure due to uncontrolled bleeding. The average operative time was 3.34 hours in the first 20 cases during the learning phase, decreasing to 2.10 hours in the last 20 cases. Intraoperative blood loss ranged from 50 to 200 ml, with an average of 60 ml. Transient recurrent laryngeal nerve palsy occurred in 2 cases, 3 cases developed infections, and 2 cases had seroma formation. Conclusion: TOETVA appears to be a safe and effective minimally invasive technique for selected thyroid pathologies in the Bangladeshi population. The procedure demonstrates excellent cosmetic outcomes with a low complication rate, making it a viable alternative to traditional thyroidectomy approaches.
Transoral Endoscopic; Thyroidectomy Vestibular Approach; TOETVA; Thyroidectomy; NOTES; Minimal surgical intervention.
Alam M, Hasan DM, Islam GT, Khanam M, Hussain T, Matin A. Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA): Study of 80 Cases. Am J Otolaryngol Head Neck Surg. 2025; 8(1): 1264..