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BackTable / ENT / Podcast / Episode #139

Radiofrequency Ablation: Modern Management of Thyroid Nodules

with Dr. David Goldenberg

In this episode of BackTable ENT, Dr. Gopi Shah and Dr. David Goldenberg, head and neck surgeon and department chair at PennState Health in Pennsylvania, discuss radiofrequency ablation (RFA) of thyroid nodules.

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Radiofrequency Ablation: Modern Management of Thyroid Nodules with Dr. David Goldenberg on the BackTable ENT Podcast)
Ep 139 Radiofrequency Ablation: Modern Management of Thyroid Nodules with Dr. David Goldenberg
00:00 / 01:04

BackTable, LLC (Producer). (2023, October 31). Ep. 139 – Radiofrequency Ablation: Modern Management of Thyroid Nodules [Audio podcast]. Retrieved from https://www.backtable.com

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Podcast Contributors

Dr. David Goldenberg discusses Radiofrequency Ablation: Modern Management of Thyroid Nodules on the BackTable 139 Podcast

Dr. David Goldenberg

Dr. David Goldenberg is a professor and the chair of the department of otolaryngology - head and neck surgery at Penn State in Hershey, Pennsylvania.

Dr. Gopi Shah discusses Radiofrequency Ablation: Modern Management of Thyroid Nodules on the BackTable 139 Podcast

Dr. Gopi Shah

Dr. Gopi Shah is a practicing ENT at UT Southwestern Medical Center in Dallas, TX.

Synopsis

First, Gopi and David review workup of thyroid nodules. Before considering RFA, patients need thyroid function tests, ultrasound imaging, and a biopsy showing benign disease. In David’s opinion, radiofrequency ablation is a good option for benign nodules larger than two centimeters that are enlarging and causing compressive symptoms. RFA is not appropriate for malignant disease, with the potential application for papillary microcarcinoma, which is currently being evaluated in other parts of the world.

Next, David outlines how he performs RFA. Using a combination of mild sedation, local anesthesia, and regional anesthesia, he performs this procedure in-office under continuous ultrasound guidance. Radiofrequency ablation uses heat to cause coagulative necrosis of nodular tissue. After cervical block and anesthetization of the thyroid capsule, David introduces the RFA probe through a small midline neck incision. Drawing on the “moving shock technique,” he moves the RFA probe back and forth, watching for signs of tissue necrosis on ultrasound. Complications of RFA are similar to those of thyroid surgery, but they occur at lower rates due to the less invasive nature of this procedure.

Finally, the conversation places RFA in a larger context for the thyroid surgeon. RFA patients return to the clinic that same week for a physical exam. Surveillance ultrasounds occur six and twelve months post-procedure. David counsels his patients that their nodule will not shrink immediately, and may swell in the days following their procedure. However, he expects the nodule to shrink 50-80% in the year following RFA. The podcast wraps up with an overview of how to bring RFA to your practice.

Resources

Disclaimer: The Materials available on BackTable.com are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.

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Thyroid Nodules Condition Overview

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