A large study shows that percutaneous combined intraoperative neuromonitoring significantly reduces vocal cord palsy in transoral endoscopic thyroidectomy.

• Percutaneous-combined group had a temporary vocal cord palsy rate of just 0.2%, vastly lower than other techniques.
• Independent protective factor against vocal cord palsy, with odds ratio of 0.08; thyroid malignancy and Graves’ disease increase risk.

Consider percutaneous combined neuromonitoring for high-risk thyroid patients to improve surgical outcomes.