Minimal Endoscope-assisted Thyroidectomy Through a Retroauricular Approach: An Evolving Solo Surgery Technique

This study aimed to evaluate the feasibility and efficacy of minimal endoscope-assisted thyroidectomy (MEAT) through a retroauricular (RA) approach. Most of the thyroidectomy operative time was accounted for by direct visualization through the RA window, minimizing interference between surgical instruments. Endoscope use was minimized and limited to critical surgical aspects, including preservation of the recurrent laryngeal nerve and parathyroid glands. The recurrent laryngeal nerve was neuromonitored throughout the procedure. MEAT through an RA approach was performed in 8 patients with papillary thyroid carcinoma (mean tumor size, 1.2±0.5 cm). The mean patient age was 41.1±7.5 years. The endoscopic operating time was 19±3.4 minutes, and no postoperative hematoma, seroma, or vocal cord paralysis was observed. MEAT through an RA approach was feasible and safe. Solo thyroidectomy through the RA approach is possible without depending on an endoscopic view, overcoming limited working space and minimizing instrument interference during endoscopic RA thyroidectomy.