Safety and cosmetic results of trans-submental endoscopic thyroidectomy

The increasing incidence of thyroid tumors, combined with patients' growing emphasis on cosmetic outcomes, has fueled advancements in endoscopic thyroidectomy techniques. This study aims to evaluate the safety, feasibility, and aesthetic outcomes of trans-submental endoscopic thyroidectomy (TSET), a novel approach designed to overcome the limitations of the oral vestibular route. Clinical data from 95 patients who underwent TSET at our institution between May 2022 and December 2024 were retrospectively analyzed. Inclusion criteria were benign thyroid nodules ≤ 4 cm or papillary thyroid carcinoma (PTC) ≤ 3 cm without lateral neck or distant metastasis. Surgical outcomes, complications, and patient satisfaction were systematically assessed. Of the 96 patients initially enrolled, one required conversion to open thyroidectomy due to intraoperative bleeding. The remaining 95 patients successfully completed TSET, including 48 unilateral partial thyroidectomies, 6 bilateral partial thyroidectomies, 38 lobectomies with unilateral central neck dissection (UCND), and 3 total thyroidectomies with UCND. The mean operative time was 158.3 ± 40.1 min. No permanent complications, such as recurrent laryngeal nerve (RLN) injury or hypoparathyroidism, were observed. Transient RLN palsy occurred in 2 patients and resolved with conservative management. Aesthetic outcomes were highly satisfactory, with hidden submental scars and no postoperative infections reported. During the follow-up period (mean: 14.0 ± 7.7 months), no tumor recurrence was observed. TSET is a safe and feasible surgical approach with good cosmetic results and shows promising development prospects.