CLINICAL TRIAL article
Front. Endocrinol.
Sec. Thyroid Endocrinology
Endoscopic Thyroidectomy via the Submental Approach: A Balanced Approach to Aesthetics, Safety, and Recovery-a case series study
Provisionally accepted
- Hunan Cancer Hospital, Xiangya School of Medicine, Central South University, Changsha, China
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Objective To overcome certain anatomical limitations of transoral vestibular thyroidectomy, we introduced endoscopic thyroidectomy via the submental approach. During subsequent clinical practice, additional advantages of the submental approach were identified, further enhancing its feasibility and clinical applicability. This study aimed to evaluate the safety, efficacy, and postoperative outcomes of this technique in thyroid surgery. Methods We retrospectively analyzed patients who underwent endoscopic thyroidectomy via the submental approach at Hunan Cancer Hospital between March and September 2023. Perioperative outcomes, complications, and postoperative quality of life were assessed using validated clinical indicators and the Thyroid Cancer-Specific Quality of Life questionnaire. Results A total of 50 patients (27 males, 23 females; mean age 41.66±9.70 years) were included. The mean operative time was 93.61 ± 21.78 minutes for unilateral thyroidectomy and 137.39 ± 27.76 minutes for total thyroidectomy. The mean pain score at 48 hours postoperatively was 1.56±0.61, and the mean postoperative hospital stay was 2.84±0.81 days. The mean aesthetic satisfaction score was 4.28±0.67 (1–5, with higher scores indicating better satisfaction). The mean quality-of-life score was 10.23±5.33 (0–130, with lower scores indicating better quality of life). No surgical site infections occurred. Transient hypoparathyroidism occurred in 14.8% of patients, and transient recurrent laryngeal nerve palsy occurred in 4.00%. The mean follow-up duration was 22 months, and no cases of recurrence or distant metastasis were observed during the follow-up period. Conclusions Endoscopic thyroidectomy via the submental approach effectively balances cosmetic outcomes, surgical trauma, oncological integrity, and surgical feasibility, providing a promising alternative for endoscopic thyroidectomy. Further prospective, multicenter studies are needed to validate its long-term safety and broader clinical applicability. Trial registration number and date: Chinese Clinical Trial Registry (UIN: ChiCTR2400089684, https://www.chictr.org.cn),2024.9.12
Keywords: Endoscopic thyroidectomy via the submental approach, Papillary thyroid carcinoma, surgical outcomes, Cosmetic satisfaction, Quality of Life, surgical feasibility
Received: 29 Sep 2025; Accepted: 09 Dec 2025.
Copyright: © 2025 Li, Li, Wu, Li, Tang, Song, Peng and Zhou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Xiaowei Peng
Shiwei Zhou
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