Thyroid is one of the most important endocrine organs in the body. When the abnormal tissues, including nodules and/or cysts, developed in the thyroid, these structural disorders of thyroid would lead to dysarthria and respiratory distress. If the condition impacts the patient' daily life, they may undergo surgery. Besides traditional surgical treatment, radiofrequency ablation of the thyroid is a new strategies of clinical approach by minimal invasive therapies; it may reduce pain and complications as well as shorten recovery time. It is a minimally invasive procedure to resolve the tumor effects and preserve thyroid function.

Nowadays, minimally invasive therapies is progressive forward, and become an ideal and new strategy for thyroid tumors.

Dr. Chia-Luen Huang, Metabolism and Endocrinologist, serves in Tri-Service General Hospital, mentioned that minimally invasive therapies, including ethanol ablation, radiofrequency ablation, microwave ablation, and high intensive focused ultrasound (HIFU), are feasible for benign tumors of the neck, as known as nodules. For papillary thyroid microcarcinoma, radiofrequency ablation plays an important role in the therapeutic strategy for thyroid cancers. Since the surgical time can be shortened significantly, with almost no scarring, and usually no hospitalization required after surgery, the medical efficiency can be effectively improved, and related complications reduced.

Ethanol ablation can be applied to large cysts in thyroid. For the one year of recurrence rate of more than 70% of cysts with repeated fluid aspirations, ethanol ablation could be performed by injecting high concentration of ethanol into the cysts. Ethanol is applied to denature the protein, then the cavity of the cysts would shrink significantly and the probability of tumor recurrence is reduced simultaneously.

Radiofrequency ablation is implemented by placing electrodes through the anterior part of neck. Surgeons perform moves shots by trans-isthmic approaching carefully and continuously. The well-designed electrodes provide energy-releasing conductivity and précised temperature control so the nodules are going to be coagulation and necrosis while proceeding radiofrequency ablation. The safety margins can be accurately confined to within 0.1-0.3 cm. Microwave ablation uses resonance molecules to produce heats with a wider ablation range for large tumors or mixed tumors in thyroid.

HIFU is similar to tumor-focused ultrasound to generate a high temperature through focusing resonance, which is a non-invasive procedure. However, the patient’s neck moves during the operation when they breathe, so HIFU coverage is not as wide and accurate as radiofrequency ablation for securing the safety range. Only one needle is required for surgery so the patient can recover quickly.

Dr. Chia-Luen Huang explained further that thyroid nodules are larger causing mass effects with clinical signs and symptoms of the tumor at the initial stage are not obvious, most cases are identified through general health checks or imaging examinations. If the nodules are larger, causing mass effects, including trachea deviation or esophageal compression, leading to dysphasia and hoarseness, even local pain or dyspnea. Most thyroid nodules are benign, but around 7% to 10% of probabilities are malignant and require further examination and assessment by cytology to confirm the cell type and nodular morphology.

If the thyroid nodules are benign and small, they may only require active surveillances; even only needed for thyroxin suppression therapy. If they have a significant impact on the patient's daily life, they will be advised to undergo surgery to remove the mass effects. Besides traditional surgery, radiofrequency ablation is the new-developing surgical interventions; only one needle is required to resolve the thyroid nodules. These new-developed approaches by minimal invasive therapies not only shorten surgical time and results in a very tiny wound, but is also quite safe and effective. The recovery time is shorter as well and radiofrequency ablation can preserve the thyroid functioning and improve the quality of life.