Artificial Intelligence in Thyroid Surgery: A new Frontier in Precision Endocrine Care

AI represents a paradigm shift in thyroid surgery, enhancing diagnostic precision, operative safety and personalized care. Its successful clinical translation will depend on rigorous validation, ethical governance, and transparent implementation frameworks. Artificial Intelligence (AI) is rapidly transforming surgical disciplines, including endocrine surgery. Thyroid surgery offers a promising landscape for AI integration due to its reliance on imaging, cytology, intraoperative precision, and long-term surveillance. This review explores the current and emerging applications of AI in thyroid surgery, highlighting its role in preoperative evaluation, intraoperative assistance, postoperative care, and surgical education. A comprehensive review of recent literature was con-ducted, focusing on AI methodologies-machine learning, deep learning, and computer vision- as applied to thyroid ultrasound, cytopathology, intraoperative nerve monitoring, parathyroid identification, risk modelling, and training systems. The use of AI improved the accuracy and consistency of thyroid nodule risk stratification. Machine learning algorithms integrating cytology and molecular data refined surgical decision-making, while AI-assisted neuromonitoring and computer vision technologies aided in identifying critical structures such as the recurrent laryngeal nerve and para-thyroid glands. Postoperatively, AI-driven predictive models showed promise in stratifying complication and recurrence risks, while NLP tools supported surveillance. AI represents a paradigm shift in thyroid surgery, enhancing diagnostic precision, operative safety and personalized care. Its successful clinical translation will depend on rigorous validation, ethical governance, and transparent implementation frameworks.