Endocrine Head & Neck Surgery
Stanford Head & Neck Center
What is Radiofrequency Ablation?
Radiofrequency ablation is a treatment that relies on heat to eliminate tissue. It has been used to treat tumors in the lung, liver, kidney, bone, and now the thyroid!
The treatment requires ultrasound for guidance, so it is important that your surgeon has expertise in ultrasound imaging and using this technology for procedures. A thin probe the size of a needle is inserted through the skin and into the target nodule. A machine then delivers an electrical current to the tip of the probe, which heats up and destroys the surrounding tissue. This results in gradual shrinkage of the thyroid nodule.
Ablation or Surgery?
The traditional treatment for a symptomatic thyroid nodule is a thyroid lobectomy. This results in complete removal of the nodule and some of the surrounding thyroid tissue. There is no tissue removed during radiofrequency ablation. Instead, the nodule is destroyed by heat, which leads to a significant decrease in size over time, such that it is no longer noticeable or causing symptoms.
For the right patient, radiofrequency ablation has some advantages over surgery. It is an outpatient procedure and can be done in the office under local anesthesia. It does not require an incision. Normal thyroid tissue surrounding nodules is preserved and results in significantly lower likelihood of needing thyroid hormone supplementation. This also means nodules on both sides of the thyroid may be treated without risking hypothyroidism. Typically, only requires one treatment is needed, but ablation can certainly be repeated if indicated.
What to Expect During and After the Procedure?
Before starting the treatment, your surgeon will apply local anesthesia around the thyroid gland and surrounding tissue to ensure a comfortable procedure. Once this has taken effect, the radiofrequency probe is inserted into the target nodule. Under constant ultrasound guidance, it is moved back and forth within the nodule to ensure ablation of the intended tissue while avoiding important structures. Typically, this requires only one point of entry in the skin. For very large nodules, two different sites may be required.
The total time of the treatment will depend on the size and number of the nodule(s), but typically lasts between 30 and 45 minutes. A bandage will be applied to the skin and you may return home afterward. You may experience soreness at the treatment site and can take over-the-counter pain medication. Local swelling can be expected in the first days after the procedure, followed by steady decrease in nodule size over the next few weeks to months.
Am I a Candidate?
Radiofrequency ablation is ideal for patients with benign thyroid nodules. Many nodules do not require intervention, but when they are causing discomfort or pressure, distorting appearance, or exhibiting growth, treatment may be indicated. Prior to offering this procedure, your surgeon will confirm the target nodule is benign, and a complete neck and thyroid ultrasound will be performed to ensure it is in a location that can be treated safely and effectively.