Transoral endoscopic parathyroidectomy vestibular approach: A systematic review

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.