Tailoring the Message: A Survey of Patients' Information Needs and Preferences Before Transoral Endoscopic Thyroidectomy via the Vestibular Approach

Transoral endoscopic thyroidectomy via the vestibular approach (TOETVA) provides a scarless alternative toopen thyroidectomy but entails specific risks, particularly mental nerve injury. How patients weigh these risks against cervicalscarring and wound morbidity from open surgery remains unclear.Methods: In this prospective cross‐sectional study at a high‐volume endocrine surgery centre, 68 consecutive TOETVA patientscompleted pre‐ and postoperative surveys on informational priorities, risk recall, and satisfaction. To contextualize TOETVA‐specific morbidity and the informational trade‐offs faced by patients, we prospectively identified a contemporary open thy-roidectomy cohort and applied 1:1 nearest‐neighbor matching by age, sex, indication, and extent of resection, thereby sup-porting comparative inferences beyond simple descriptive contrasts. All patients received structured, multimodal counsellingwith centre‐specific numerical risks, and an additional questionnaire assessed how risk information influenced procedurechoice and willingness to reconsider preferences under alternative risk scenarios.Results: TOETVA patients rated procedural details, TOETVA‐specific risks—particularly mental nerve injury—and generalthyroidectomy complications as highly important (≥ 4.7/5), with recall and satisfaction exceeding 90%. In the TOETVA cohort,transient recurrent laryngeal nerve palsy occurred in 7.4% and transient hypocalcaemia in 6.1%, with no permanent events;mental nerve paraesthesia affected 30.9%, persisting at 6 months in 4.4%. Matched open thyroidectomy patients showed com-parable transient RLN palsy (5.9%) and hypocalcaemia (6.1%), but had 1.5% permanent RLN palsy, 1.5% permanent hypo-calcaemia, no mental nerve injury, and 7.4% cervical wound complications. Overall, 94% of patients considered precise numericalrisk estimates essential, and 88% reported that comparative risk information strongly influenced technique choice, with manyindicating they would reconsider preferences if rates of persistent mental nerve symptoms or neck‐scar morbidity changed.Conclusions: Patients prioritise quantified, centre‐specific risk information and use it to balance the cosmetic benefits ofTOETVA against mental nerve morbidity and the wound risks of open surgery, supporting routine integration of auditedcomplication rates into shared decision‐mak