Radiofrequency Ablation (RFA) for the treatment of thyroid nodules
Radiofrequency Ablation (RFA) is a minimally invasive, non-surgical, outpatient procedure, which shrinks the nodules without compromising thyroid function and helps avoid long recovery times of thyroid surgery.
What You Need to Know About RFA
+ Is RFA right for me?
RFA is an exciting choice for patients who experience problems from benign thyroid nodules - without the risks of RAI. RFA offers the potential for less pain, downtime, and external scarring than surgery. COMPARED with surgery, the primary advantages of radiofrequency ablation are:
- The potential for fewer complications
- Generally shorter recovery time with a quick return to normal activities
- Increased likelihood of preservation of thyroid function.
+ What are the side effects?
In a multi-center study of 1459 patients organized by the Korean Society of Thyroid Radiology, the overall complication rate following radio frequency ablation was 3.3% The major complication rate was 1.4%
While uncommon complications can include:
- Temporary voice changes, such as hoarseness.
- Slight bleeding - usually disappears on its own within one day, or at the most, up to three months.
- Wound infections
- In rare cases, vomiting, cough, or seared skin at the treatment site may occur.
- Patients with AFTN (“hot” thyroid nodules) have the possibility of hypothyroidism after the procedure.
+ How do I prepare?
RFA takes place in an outpatient setting. Although you will not be under general anesthesia, you will need to follow some pre-procedural instructions from your healthcare facility.
They will review the list of your current medications and provide instructions. In most cases, your medications will not affect the procedure. If you take medication for diabetes or high blood pressure, you will most likely be instructed to keep taking it.
If you’re on blood-thinning medication, you will probably need to stop taking it for a few days prior to the procedure. Be sure to inform your physician if you have a pacemaker, implants, are pregnant, or on any medication (especially for blood thinning). Don’t wear makeup, lipstick, or any metal jewelry on the day of the procedure.
+ Is RFA Painful?
The procedure is so gentle that most people have little to no discomfort. This is because the thyroid nodule itself is not sensitive to pain. Other than the initial injection of numbing medication, the only remaining sensation is generally pressure. Intermittent sensations of discomfort thereafter can be treated with additional doses of pain medication or adjustment of the probe tip. Radiofrequency ablation does not cause any scarring to the external neck. In many cases, one puncture of the skin is sufficient to treat the entire thyroid gland.
+ What does the procedure entail?
A generator creates an electric circuit. The electrode is designed to optimally deliver energy to the area that is being treated.
During the procedure, the doctor will place the tip of the probe into the thyroid nodule. The generator creates a high-frequency wave and sends it directly to the end of the probe. Your doctor can then adjust the area being treated as needed to ensure that you achieve the desired results.
You will often hear background noise and “mild popping” sounds throughout the procedure. These sounds are normal and signify an appropriate response is taking place.
+ How long does the procedure last?
While the procedure itself takes less than an hour, the entire process may take 2-3 hours. Pre-procedural care and post-procedural monitoring take an additional hour. When the procedure is complete, a small bandage will be placed on the treatment site and the neck may be cooled with ice packs.
+ How many treatments do I need?
For most nodules that are less than 4cm, one treatment is sufficient. For nodules that are close to vocal cord nerves, or larger nodules, repeated treatment may be necessary.
Untreated areas of “hot” nodules may interfere with the improvement in thyroid function. In these instances, complete ablation may be required. For this reason, more than one treatment session may be necessary to successfully treat “hot” nodules.
+ What should I expect after the procedure?
After monitoring for a short period of time, you will be discharged. Please check with your doctor before you drive, as you may need someone to drive you to and from the procedure. You should be able to return to most of your regular daily activities almost immediately.
The entire procedure takes between fifteen minutes to one hour. Because it is minimally invasive and does not require general anesthesia, you avoid the scarring of traditional thyroid surgery and the associated risks of anesthesia. Radiofrequency ablation may also minimize the risk of permanent damage to the vocal cord nerve or to the parathyroid glands.
+ Is RFA covered by insurance?
Currently, most insurance does not cover the procedure, however, patients can pay through a payment plan or Care Credit Program.
One of the most meaningful long-term advantages of RFA that you may not need to take lifelong thyroid medication. The treatment preserves healthy thyroid tissue, which allows the thyroid to continue functioning normally - no ongoing medication management, with the difficulties of achieving the correct thyroid hormone dosage.
To find out more about RFA and schedule an appointment call ELK Medical today!
