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Effectiveness of Injecting Cold 5% Dextrose into Patients with Nerve Damage Symptoms during Thyroid Radiofrequency Ablation

Endocrinology and Metabolism
2020년 35권 2호 p.407 ~ p.415
이민경 ( Lee Min-Kyoung ) - University of Ulsan College of Medicine Asan Medical Center Department of Radiology

백정환 ( Baek Jung-Hwan ) - University of Ulsan College of Medicine Asan Medical Center Department of Radiology
정새롬 ( Chung Sae-Rom ) - University of Ulsan College of Medicine Asan Medical Center Department of Radiology
최영준 ( Choi Young-Jun ) - University of Ulsan College of Medicine Asan Medical Center Department of Radiology
이유미 ( Lee Yu-Mi ) - University of Ulsan College of Medicine Asan Medical Center Department of Surgery
김태영 ( Kim Tae-Yong ) - University of Ulsan College of Medicine Asan Medical Center Department of Internal Medicine
이정현 ( 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°C to 4°C) 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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