Effectiveness of Injecting Cold 5% Dextrose into Patients with Nerve Damage Symptoms during Thyroid Radiofrequency Ablation
Endocrinology and Metabolism 2020³â 35±Ç 2È£ p.407 ~ p.415
À̹ΰæ(Lee Min-Kyoung) - University of Ulsan College of Medicine Asan Medical Center Department of Radiology
¹éÁ¤È¯(Baek Jung-Hwan) - University of Ulsan College of Medicine Asan Medical Center Department of Radiology
Á¤»õ·Ò(Chung Sae-Rom) - University of Ulsan College of Medicine Asan Medical Center Department of Radiology
ÃÖ¿µÁØ(Choi Young-Jun) - University of Ulsan College of Medicine Asan Medical Center Department of Radiology
ÀÌÀ¯¹Ì(Lee Yu-Mi) - University of Ulsan College of Medicine Asan Medical Center Department of Surgery
±èÅ¿µ(Kim Tae-Yong) - University of Ulsan College of Medicine Asan Medical Center Department of Internal Medicine
ÀÌÁ¤Çö(Lee Jeong-Hyun) - University of Ulsan College of Medicine Asan Medical Center Department of Radiology
Abstract
Background: Although radiofrequency ablation (RFA) is a safe treatment for thyroid tumors, nerve damage is a frequent complication. A previous retrospective study suggested that an injection of cold 5% dextrose in water (5% DW) can reduce nerve damage during RFA. This study validated the efficacy of injecting cold 5% DW for management of nerve damage during RFA.
Methods: Between November 2017 and December 2018, 242 patients underwent 291 RFA sessions for treatment of benign thyroid nodules or recurrent thyroid cancers. Using a standardized technique, cold (0¡ÆC to 4¡ÆC) 5% DW was immediately injected around the damaged nerve into patients with any symptoms suggesting nerve damage. The incidence of nerve damage, the volume of 5% DW injected, symptom recovery time and the incidence of permanent nerve damage were evaluated.
Results: Nineteen patients experienced nerve damage symptoms related to 21 RFA sessions, including 17 patients during 19 sessions and two patients on the day after two sessions. Patients with nerve damage symptoms detected during RFA were treated by injection of a mean 41 mL (range, 3 to 260) cold 5% DW, but the two patients who experienced symptoms the next day did not receive cold 5% DW injections. Immediate recovery was observed after 15 RFA sessions in 14 patients. No patient experienced permanent nerve damage.
Conclusion: Injection of cold 5% DW is effective in managing nerve damage during RFA of thyroid lesions.
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Thyroid nodule, Radiofrequency ablation, Ultrasonography
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This study showed that injection of cold 5% DW was effective in managing suspected nerve damage during RFA. This technique is effective in controlling thermal damage to nerves, and may encourage curative ablation for recurrent thyroid cancer.