{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T15:35:24Z","timestamp":1791387324679,"version":"4.3.3"},"reference-count":19,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2022,6,28]],"date-time":"2022-06-28T00:00:00Z","timestamp":1656374400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>In the transoral endoscopic thyroidectomy vestibular approach (TOETVA), three oral vestibular incisions are used to access the thyroid. This approach leaves no scar on the body surface; however, unexpected complications may occur. Three patients (two women, one man) underwent TOETVA using the standard three-port technique. Broken cannulas of the 12 mm central port were noted in all cases. All cannulas broke on the ventral side of the distal shaft. The fracture lines were 3\u20134 cm in length, with some fragments scattered throughout the operative field and oral cavity. The fractures were caused by compression against the mandible while tilting the cannula during surgical manipulation. Male sex, short stature, and protruding chin may be risk factors for cannula fracture in TOETVA. Measures should be taken to prevent this complication, particularly in high-risk patients.<\/jats:p>","DOI":"10.3390\/diagnostics12071566","type":"journal-article","created":{"date-parts":[[2022,6,28]],"date-time":"2022-06-28T23:59:22Z","timestamp":1656460762000},"page":"1566","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Cannula Fracture during Transoral Endoscopic Thyroidectomy Vestibular Approach: Causes and Prevention"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4005-7661","authenticated-orcid":false,"given":"Tsung-Jung","family":"Liang","sequence":"first","affiliation":[{"name":"Division of General Surgery, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan"},{"name":"School of Medicine, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiuh-Inn","family":"Liu","sequence":"additional","affiliation":[{"name":"Division of General Surgery, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan"},{"name":"School of Medicine, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I-Shu","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of General Surgery, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,6,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1007\/s00268-015-3320-1","article-title":"Transoral endoscopic thyroidectomy vestibular approach: A series of the first 60 human cases","volume":"40","author":"Anuwong","year":"2016","journal-title":"World J. 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