Academic Journal
Προβολή σε EDS

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

Λεπτομέρειες βιβλιογραφικής εγγραφής
Τίτλος: Clinical outcomes of percutaneous versus peroral intraoperative neuromonitoring strategies in transoral endoscopic thyroidectomy vestibular approach: A retrospective analysis of 2,201 patients.
Συγγραφείς: Uen YH; Department of Surgery, Asia University Hospital, Taichung, Taiwan; Department of Surgery, Tainan Municipal An-Nan Hospital, Tainan, Taiwan; Uen YH Surgical Clinic, Tainan, Taiwan., Wu CW; Department of Otorhinolaryngology- Head and Neck Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan., Wen KS; Department of Pharmacy, Chi Mei Medical Center, Tainan, Taiwan., Lin YF; Department of Surgery, Chi Mei Medical Center, Tainan, Taiwan., Lin KY; Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan. Electronic address: d84306@yahoo.com.tw.
Πηγή: Surgery [Surgery] 2026 Oct; Vol. 198, pp. 110432. Date of Electronic Publication: 2026 Jul 01.
Τύπος έκδοσης: Journal Article; Comparative Study
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Mosby Country of Publication: United States NLM ID: 0417347 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-7361 (Electronic) Linking ISSN: 00396060 NLM ISO Abbreviation: Surgery Subsets: MEDLINE
Imprint Name(s): Publication: St. Louis, MO : Mosby
Original Publication: St. Louis.
Ιατρικοί όροι (MeSH): Thyroidectomy*/methods , Thyroidectomy*/adverse effects , Vocal Cord Paralysis*/prevention & control , Vocal Cord Paralysis*/etiology , Vocal Cord Paralysis*/epidemiology , Recurrent Laryngeal Nerve Injuries*/prevention & control , Recurrent Laryngeal Nerve Injuries*/etiology , Recurrent Laryngeal Nerve Injuries*/epidemiology , Recurrent Laryngeal Nerve Injuries*/diagnosis , Natural Orifice Endoscopic Surgery*/adverse effects , Natural Orifice Endoscopic Surgery*/methods , Intraoperative Neurophysiological Monitoring*/methods , Postoperative Complications*/prevention & control , Postoperative Complications*/etiology , Postoperative Complications*/epidemiology, Humans ; Female ; Retrospective Studies ; Male ; Middle Aged ; Adult ; Treatment Outcome ; Risk Factors ; Aged
Περίληψη: Background: 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.
Methods: This large-scale, retrospective cohort study, based on a prospectively collected database, enrolled 2,201 patients who underwent transoral endoscopic thyroidectomy vestibular approach. We compared outcomes among 3 distinct groups: nonintraoperative neuromonitoring (n = 109), peroral intraoperative neuromonitoring (n = 582, year 2016-2019), and percutaneous intraoperative neuromonitoring (n = 1,510, year 2020-May 2025). The peroral and percutaneous groups were further analyzed according to the technique used: intermittent (intermittent intraoperative neuromonitoring) or combined (intermittent intraoperative neuromonitoring + continuous intraoperative neuromonitoring). End points were the incidence of vocal cord palsy and a multivariate analysis of independent risk factors for vocal cord palsy.
Results: The 2,092 intraoperative neuromonitoring patients (peroral and percutaneous) were analyzed in 4 subgroups: peroral intermittent intraoperative neuromonitoring (n = 481), peroral combined (intermittent intraoperative neuromonitoring + continuous intraoperative neuromonitoring, n = 101), percutaneous intermittent intraoperative neuromonitoring (n = 1,100), and percutaneous combined (intermittent intraoperative neuromonitoring + continuous intraoperative neuromonitoring, n = 410). Among these, the percutaneous combination (percutaneous-combined) group had a significantly lower temporary vocal cord palsy rate (0.2%) than all other groups (P < .05). This was attributed to higher technical success: percutaneous-combined intraoperative neuromonitoring achieved higher rates of persistent vagus nerve stimulation (99.7% vs 94.4%), a higher detection rate of imminent recurrent laryngeal nerve injury (4.4% vs 0.7%, P < .05), and a higher intraoperative signal recovery rate (88.9% vs 33.3%). Permanent vocal cord palsy was rare (n = 2), occurring only in the peroral groups. Critically, multivariate analysis confirmed that percutaneous combination intraoperative neuromonitoring was an independent protective factor against vocal cord palsy (odds ratio, 0.08; P = .02), whereas thyroid malignancy (odds ratio, 2.02; P = .02) and Graves disease/thyroiditis (odds ratio, 2.19; P = .03) were 2 independent risk factors.
Conclusion: This large-scale study confirms that the percutaneous application of combined intermittent intraoperative neuromonitoring and continuous intraoperative neuromonitoring is a safe, feasible, and effective strategy for protecting the recurrent laryngeal nerve in the transoral endoscopic thyroidectomy vestibular approach. It is associated with reduced vocal cord palsy rates and can be considered a viable option, especially for individuals with high-risk thyroid diseases.
(Copyright © 2026 Elsevier Inc. All rights reserved.)
Competing Interests: Conflict of Interest/Disclosure The authors have no related conflicts of interest to declare.
Entry Date(s): Date Created: 20260720 Date Completed: 20260915 Latest Revision: 20260915
Update Code: 20260916
DOI: 10.1016/j.surg.2026.110432
PMID: 42475946
Βάση Δεδομένων: MEDLINE
FullText Text:
  Availability: 0
CustomLinks:
  – Url: https://www.doi.org/10.1016/j.surg.2026.110432?
    Name: ScienceDirect (all content) (s7799221)
    Category: fullText
    Text: View record from ScienceDirect
    MouseOverText: View record from ScienceDirect
  – Url: https://resolver.ebsco.com/c/fiv2js/result?sid=EBSCO:cmedm&genre=article&issn=15327361&ISBN=&volume=198&issue=&date=20261001&spage=110432&pages=110432&title=Surgery&atitle=Clinical%20outcomes%20of%20percutaneous%20versus%20peroral%20intraoperative%20neuromonitoring%20strategies%20in%20transoral%20endoscopic%20thyroidectomy%20vestibular%20approach%3A%20A%20retrospective%20analysis%20of%202%2C201%20patients.&aulast=Uen%20YH&id=DOI:10.1016/j.surg.2026.110432
    Name: Full Text Finder (for New FTF UI) (ns324271)
    Category: fullText
    Text: Full Text Finder
    MouseOverText: Full Text Finder
Header DbId: cmedm
DbLabel: MEDLINE
An: 42475946
AccessLevel: 3
PubType: Academic Journal
PubTypeId: academicJournal
PreciseRelevancyScore: 0
IllustrationInfo
Items – Name: Title
  Label: Title
  Group: Ti
  Data: Clinical outcomes of percutaneous versus peroral intraoperative neuromonitoring strategies in transoral endoscopic thyroidectomy vestibular approach: A retrospective analysis of 2,201 patients.
– Name: Author
  Label: Authors
  Group: Au
  Data: &lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Uen+YH%22&quot;&gt;Uen YH&lt;/searchLink&gt;; Department of Surgery, Asia University Hospital, Taichung, Taiwan; Department of Surgery, Tainan Municipal An-Nan Hospital, Tainan, Taiwan; Uen YH Surgical Clinic, Tainan, Taiwan.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Wu+CW%22&quot;&gt;Wu CW&lt;/searchLink&gt;; Department of Otorhinolaryngology- Head and Neck Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Wen+KS%22&quot;&gt;Wen KS&lt;/searchLink&gt;; Department of Pharmacy, Chi Mei Medical Center, Tainan, Taiwan.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Lin+YF%22&quot;&gt;Lin YF&lt;/searchLink&gt;; Department of Surgery, Chi Mei Medical Center, Tainan, Taiwan.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Lin+KY%22&quot;&gt;Lin KY&lt;/searchLink&gt;; Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan. Electronic address: d84306@yahoo.com.tw.
– Name: TitleSource
  Label: Source
  Group: Src
  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%220417347%22&quot;&gt;Surgery&lt;/searchLink&gt; [Surgery] 2026 Oct; Vol. 198, pp. 110432. &lt;i&gt;Date of Electronic Publication: &lt;/i&gt;2026 Jul 01.
– Name: TypePub
  Label: Publication Type
  Group: TypPub
  Data: Journal Article; Comparative Study
– Name: Language
  Label: Language
  Group: Lang
  Data: English
– Name: TitleSource
  Label: Journal Info
  Group: Src
  Data: &lt;i&gt;Publisher: &lt;/i&gt;&lt;searchLink fieldCode=&quot;PB&quot; term=&quot;%22Mosby%22&quot;&gt;Mosby &lt;/searchLink&gt;&lt;i&gt;Country of Publication: &lt;/i&gt;United States &lt;i&gt;NLM ID: &lt;/i&gt;0417347 &lt;i&gt;Publication Model: &lt;/i&gt;Print-Electronic &lt;i&gt;Cited Medium: &lt;/i&gt;Internet &lt;i&gt;ISSN: &lt;/i&gt;1532-7361 (Electronic) &lt;i&gt;Linking ISSN: &lt;/i&gt;&lt;searchLink fieldCode=&quot;IS&quot; term=&quot;%2200396060%22&quot;&gt;00396060 &lt;/searchLink&gt;&lt;i&gt;NLM ISO Abbreviation: &lt;/i&gt;Surgery &lt;i&gt;Subsets: &lt;/i&gt;MEDLINE
– Name: PublisherInfo
  Label: Imprint Name(s)
  Group: PubInfo
  Data: &lt;i&gt;Publication&lt;/i&gt;: St. Louis, MO : Mosby&lt;br /&gt;&lt;i&gt;Original Publication&lt;/i&gt;: St. Louis.
– Name: SubjectMESH
  Label: MeSH Terms
  Group: Su
  Data: &lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Thyroidectomy%22&quot;&gt;Thyroidectomy*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Thyroidectomy+methods%22&quot;&gt;methods&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Thyroidectomy%22&quot;&gt;Thyroidectomy*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Thyroidectomy+adverse+effects%22&quot;&gt;adverse effects&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Vocal+Cord+Paralysis%22&quot;&gt;Vocal Cord Paralysis*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Vocal+Cord+Paralysis+prevention+%26+control%22&quot;&gt;prevention &amp; control&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Vocal+Cord+Paralysis%22&quot;&gt;Vocal Cord Paralysis*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Vocal+Cord+Paralysis+etiology%22&quot;&gt;etiology&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Vocal+Cord+Paralysis%22&quot;&gt;Vocal Cord Paralysis*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Vocal+Cord+Paralysis+epidemiology%22&quot;&gt;epidemiology&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Recurrent+Laryngeal+Nerve+Injuries%22&quot;&gt;Recurrent Laryngeal Nerve Injuries*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Recurrent+Laryngeal+Nerve+Injuries+prevention+%26+control%22&quot;&gt;prevention &amp; control&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Recurrent+Laryngeal+Nerve+Injuries%22&quot;&gt;Recurrent Laryngeal Nerve Injuries*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Recurrent+Laryngeal+Nerve+Injuries+etiology%22&quot;&gt;etiology&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Recurrent+Laryngeal+Nerve+Injuries%22&quot;&gt;Recurrent Laryngeal Nerve Injuries*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Recurrent+Laryngeal+Nerve+Injuries+epidemiology%22&quot;&gt;epidemiology&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Recurrent+Laryngeal+Nerve+Injuries%22&quot;&gt;Recurrent Laryngeal Nerve Injuries*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Recurrent+Laryngeal+Nerve+Injuries+diagnosis%22&quot;&gt;diagnosis&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Natural+Orifice+Endoscopic+Surgery%22&quot;&gt;Natural Orifice Endoscopic Surgery*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Natural+Orifice+Endoscopic+Surgery+adverse+effects%22&quot;&gt;adverse effects&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Natural+Orifice+Endoscopic+Surgery%22&quot;&gt;Natural Orifice Endoscopic Surgery*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Natural+Orifice+Endoscopic+Surgery+methods%22&quot;&gt;methods&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Intraoperative+Neurophysiological+Monitoring%22&quot;&gt;Intraoperative Neurophysiological Monitoring*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Intraoperative+Neurophysiological+Monitoring+methods%22&quot;&gt;methods&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Postoperative+Complications%22&quot;&gt;Postoperative Complications*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Postoperative+Complications+prevention+%26+control%22&quot;&gt;prevention &amp; control&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Postoperative+Complications%22&quot;&gt;Postoperative Complications*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Postoperative+Complications+etiology%22&quot;&gt;etiology&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Postoperative+Complications%22&quot;&gt;Postoperative Complications*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Postoperative+Complications+epidemiology%22&quot;&gt;epidemiology&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Humans%22&quot;&gt;Humans&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Female%22&quot;&gt;Female&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Retrospective+Studies%22&quot;&gt;Retrospective Studies&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Male%22&quot;&gt;Male&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Middle+Aged%22&quot;&gt;Middle Aged&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Adult%22&quot;&gt;Adult&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Treatment+Outcome%22&quot;&gt;Treatment Outcome&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Risk+Factors%22&quot;&gt;Risk Factors&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Aged%22&quot;&gt;Aged&lt;/searchLink&gt;
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: 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.&lt;br /&gt;Methods: This large-scale, retrospective cohort study, based on a prospectively collected database, enrolled 2,201 patients who underwent transoral endoscopic thyroidectomy vestibular approach. We compared outcomes among 3 distinct groups: nonintraoperative neuromonitoring (n = 109), peroral intraoperative neuromonitoring (n = 582, year 2016-2019), and percutaneous intraoperative neuromonitoring (n = 1,510, year 2020-May 2025). The peroral and percutaneous groups were further analyzed according to the technique used: intermittent (intermittent intraoperative neuromonitoring) or combined (intermittent intraoperative neuromonitoring + continuous intraoperative neuromonitoring). End points were the incidence of vocal cord palsy and a multivariate analysis of independent risk factors for vocal cord palsy.&lt;br /&gt;Results: The 2,092 intraoperative neuromonitoring patients (peroral and percutaneous) were analyzed in 4 subgroups: peroral intermittent intraoperative neuromonitoring (n = 481), peroral combined (intermittent intraoperative neuromonitoring + continuous intraoperative neuromonitoring, n = 101), percutaneous intermittent intraoperative neuromonitoring (n = 1,100), and percutaneous combined (intermittent intraoperative neuromonitoring + continuous intraoperative neuromonitoring, n = 410). Among these, the percutaneous combination (percutaneous-combined) group had a significantly lower temporary vocal cord palsy rate (0.2%) than all other groups (P &amp;lt; .05). This was attributed to higher technical success: percutaneous-combined intraoperative neuromonitoring achieved higher rates of persistent vagus nerve stimulation (99.7% vs 94.4%), a higher detection rate of imminent recurrent laryngeal nerve injury (4.4% vs 0.7%, P &amp;lt; .05), and a higher intraoperative signal recovery rate (88.9% vs 33.3%). Permanent vocal cord palsy was rare (n = 2), occurring only in the peroral groups. Critically, multivariate analysis confirmed that percutaneous combination intraoperative neuromonitoring was an independent protective factor against vocal cord palsy (odds ratio, 0.08; P = .02), whereas thyroid malignancy (odds ratio, 2.02; P = .02) and Graves disease/thyroiditis (odds ratio, 2.19; P = .03) were 2 independent risk factors.&lt;br /&gt;Conclusion: This large-scale study confirms that the percutaneous application of combined intermittent intraoperative neuromonitoring and continuous intraoperative neuromonitoring is a safe, feasible, and effective strategy for protecting the recurrent laryngeal nerve in the transoral endoscopic thyroidectomy vestibular approach. It is associated with reduced vocal cord palsy rates and can be considered a viable option, especially for individuals with high-risk thyroid diseases.&lt;br /&gt; (Copyright &#169; 2026 Elsevier Inc. All rights reserved.)
– Name: Abstract
  Label: Competing Interests
  Group: Ab
  Data: Conflict of Interest/Disclosure The authors have no related conflicts of interest to declare.
– Name: DateEntry
  Label: Entry Date(s)
  Group: Date
  Data: &lt;i&gt;Date Created: &lt;/i&gt;20260720 &lt;i&gt;Date Completed: &lt;/i&gt;20260915 &lt;i&gt;Latest Revision: &lt;/i&gt;20260915
– Name: DateUpdate
  Label: Update Code
  Group: Date
  Data: 20260916
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1016/j.surg.2026.110432
– Name: AN
  Label: PMID
  Group: ID
  Data: 42475946
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=cmedm&AN=42475946
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1016/j.surg.2026.110432
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        StartPage: 110432
    Subjects:
      – SubjectFull: Humans
        Type: general
      – SubjectFull: Female
        Type: general
      – SubjectFull: Retrospective Studies
        Type: general
      – SubjectFull: Male
        Type: general
      – SubjectFull: Middle Aged
        Type: general
      – SubjectFull: Adult
        Type: general
      – SubjectFull: Treatment Outcome
        Type: general
      – SubjectFull: Risk Factors
        Type: general
      – SubjectFull: Aged
        Type: general
      – SubjectFull: Thyroidectomy methods
        Type: general
      – SubjectFull: Thyroidectomy adverse effects
        Type: general
      – SubjectFull: Vocal Cord Paralysis prevention & control
        Type: general
      – SubjectFull: Vocal Cord Paralysis etiology
        Type: general
      – SubjectFull: Vocal Cord Paralysis epidemiology
        Type: general
      – SubjectFull: Recurrent Laryngeal Nerve Injuries prevention & control
        Type: general
      – SubjectFull: Recurrent Laryngeal Nerve Injuries etiology
        Type: general
      – SubjectFull: Recurrent Laryngeal Nerve Injuries epidemiology
        Type: general
      – SubjectFull: Recurrent Laryngeal Nerve Injuries diagnosis
        Type: general
      – SubjectFull: Natural Orifice Endoscopic Surgery adverse effects
        Type: general
      – SubjectFull: Natural Orifice Endoscopic Surgery methods
        Type: general
      – SubjectFull: Intraoperative Neurophysiological Monitoring methods
        Type: general
      – SubjectFull: Postoperative Complications prevention & control
        Type: general
      – SubjectFull: Postoperative Complications etiology
        Type: general
      – SubjectFull: Postoperative Complications epidemiology
        Type: general
    Titles:
      – TitleFull: Clinical outcomes of percutaneous versus peroral intraoperative neuromonitoring strategies in transoral endoscopic thyroidectomy vestibular approach: A retrospective analysis of 2,201 patients.
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Uen YH
      – PersonEntity:
          Name:
            NameFull: Wu CW
      – PersonEntity:
          Name:
            NameFull: Wen KS
      – PersonEntity:
          Name:
            NameFull: Lin YF
      – PersonEntity:
          Name:
            NameFull: Lin KY
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 10
              Text: 2026 Oct
              Type: published
              Y: 2026
          Identifiers:
            – Type: issn-electronic
              Value: 1532-7361
          Numbering:
            – Type: volume
              Value: 198
          Titles:
            – TitleFull: Surgery
              Type: main
ResultId 1