Complications Following Radiofrequency Ablation of Benign Thyroid Nodules

Abstract

Objective:This systematic review examined whether radiofrequency ablation (RFA) is a safe treatment modality for benign thyroid nodules (BTNs).Data Sources:PubMed, Embase, and the Cochrane Library database were searched for articles that (a) targeted human beings and (b) had a study population with BTNs that were confirmed by fine-needle aspiration cytology and/or core needle biopsy.Study Selection:Thirty-two studies relating to 3409 patients were included in this systematic review.Results:Based on literatures, no deaths were associated with the procedure, serious complications were rare, and RFA appears to be a safe and well-tolerated treatment modality. However, a broad spectrum of complications offers insights into some undesirable complications, such as track needle seeding and Horner syndrome.Conclusions:RFA appears to be a safe and well-tolerated treatment modality for BTNs. More research is needed to characterize the complications of RFA for thyroid nodules.

Management strategy for nerve damage during radiofrequency ablation of thyroid nodules

“…Nerve damage is the most common and serious major complication of RFA [22][23][24]. The recurrent laryngeal and vagus nerves are most commonly affected, with damage to the brachial plexus (n ¼ 1), cervical sympathetic ganglion (n ¼ 1), and spinal accessory nerve (n ¼ 3) having also been reported [22][23][24]31]. Nerve injury during RFA is thought to Figure 2.…”

Laser and radiofrequency ablations for benign and malignant thyroid tumors

“…Large population single-center study [41] showed that the complication rate was higher in recurrent tumors than benign ones (8.6% vs. 3.3%). Voice change was most common and serious complication, caused either by lidocaine injection, nerve compression due to hematoma, local inflammation or perineural fibrosis [42]; however, permanent damage (dysphonia or vocal cord palsy) is extremely rare [17], and most patients recovered without special treatment within 3 months [43]. Despite the rarity of permanent voice changes, a higher risk exists for patients with recurrent thyroid cancer [41].…”

“…Despite the rarity of permanent voice changes, a higher risk exists for patients with recurrent thyroid cancer [41]. Other reported complications are exceedingly rare and include Horner syndrome, brachial plexus nerve injury, transient thyrotoxicosis or hypothyroidism [43]. The application of standard techniques, a deep knowledge of the anatomy of the neck and prompt management of nerve damage is required to minimize complications.…”

Lever-elevating vs. liquid-isolating maneuvers during microwave ablation of high-risk benign thyroid nodules: a prospective single-center study

“…In particular, the incidence of injury to the recurrent laryngeal nerve during thermal ablation ranges from 0.5% to 1.2%,which was significantly lower than that of thyroidectomy (2.5-8.2%) [10][11][12][15][16][17][18][19]. In order to further decrease the risk of complications, additional research will be necessary to develop techniques to protect critical cervical structures such as the recurrent laryngeal nerve, trachea, esophagus, and cervical sympathetic trunk, et al [5,12,15,20,21].…”