Protective effect of complete endoscopic thyroidectomy through different approaches on the recurrent laryngeal nerve

IntroductionPapillary thyroid carcinoma (PTC), a malignancy originating from the thyroid follicular epithelium. AimThis study aimed to evaluate the protective effect of complete endoscopic thyroidectomy (CET) via different approaches on the recurrent laryngeal nerve (RLN). Materials and methodsThe clinical data of 100 patients with clinically node-negative PTC who underwent CET via the breast approach from February 2023 to February 2025 were retrospectively analyzed.The patients were divided into a control group (n = 55, CET via the axillary approach) and a study group (n = 45, CET via the clavicular approach). ResultsPostoperative assessments showed significant improvements in amplitude perturbation, fundamental frequency perturbation, harmonic-to-noise ratio, and normalized noise energy in both groups, with the study group demonstrating superior results (P <0.05).One month after surgery, the voice handicap index score decreased in both groups compared to preoperative levels, with a lower score in the study group (P <0.05).The Scar Cosmesis Assessment and Rating score increased postoperatively in both groups, with a higher score in the study group (P <0.05).The Short Form-36 Heath Status Questionnaire scores increased across all dimensions postoperatively in both groups, with the study group showing greater improvements (P <0.05). ConclusionsCompared with the axillary approach, CET via the clavicular approach is associated with shorter operative time and postoperative hospital stay, reduced intraoperative blood loss, and higher complete exposure rates of the central region.