Transoral endoscopic parathyroidectomy vestibular approach: A systematic review

Payam Entezami, Lindsay Boven, Erin Ware, Brent A Chang
American Journal of Otolaryngology 2021, 42 (1): 102810

BACKGROUND: Transoral endoscopic parathyroidectomy vestibular approach (TOEPVA) is a novel surgical approach that has gained increasing traction as a remote access approach for parathyroid surgery. The primary aim of this systematic review is to assess the feasibility and safety of this approach.

METHODS: Several databases were screened for relevant citations. The quality of studies and risk of bias were evaluated using the MINORS scoring system.

RESULTS: Nine articles containing 78 cases of TOEPVA met the inclusion criteria. Overall, there was a 96% success rate. There were three cases (3.8%) that had complications, including one case of transient recurrent laryngeal nerve palsy. The average MINORS score of the studies suggested a moderate amount of bias.

CONCLUSIONS: Based on limited quality evidence, this review suggests that TOEPVA is safe and feasible, with reasonable success rates and low complication rates in a very carefully selected patient population. Further large-scale studies are warranted.

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