Ultrasound-guided ethanol ablation for cystic thyroid nodules: effectiveness of the small amounts of ethanol in a single-session
Woojin Cho1 , Jung Suk Sim2 , So Lyung Jung3
1Department of Otolaryngology-Head and Neck Surgery, Withsim Clinic, Seongnam-si, Korea
2Department of Radiology, Withsim Clinic, Seongnam-si, Korea
3Department of Radiology, Yeouido St. Mary’s Hospital, The Catholic University of Korea, Seoul, Korea
Corresponding Author: So Lyung Jung ,Tel: 010-7756-6288, Fax: 02-599-6771, Email: sljung1@catholic.ac.kr
Received: October 29, 2020;  Accepted: December 22, 2020.  Published online: December 22, 2020.
ABSTRACT
Purpose:
To evaluate the efficacy of ethanol ablation (EA) in the treatment of cystic thyroid nodules using low dose ethanol regardless of initial volume of the nodule or aspirates.
Methods:
Sixty-one nodules in 60 patients were treated with EA from October 2013 to January 2020. In each patient, EA was performed only once using less than 5mL ethanol (99.5%) instilled and removed completely after a few minutes of retention. Nodule volume, symptom score, cosmetic score and complications were evaluated before and after treatment. Therapeutic success rate (TSR) and volume reduction rate (VRR) according to nodule volume and properties of the aspirates were evaluated. Therapeutic success was defined as the absence of any residual fluid or sufficient volume reduction (≥50%) with improvement of nodule-related symptoms.
Results:
Sixty-one nodules were 38 of pure cysts and 23 of predominantly cystic nodules. The initial nodule volume was 21.9 ± 15.2mL (range 4.4-77.2 mL). TSR was 88.5% (100% in pure cysts and 69.6% in predominantly cystic nodules, p<0.001). TSR of pure cysts was 100% regardless of nodule volume and properties of aspirates. In predominantly cystic nodules, TSR and VRR were gradually decreased as volume increases. One patient experienced arrhythmia during the procedure, but completely recovered without sequelae.
Conclusion:
Single-session EA using low dose ethanol might be effective in the treatment of symptomatic cystic thyroid nodules regardless of initial volume and properties of aspirates, especially in pure cysts.
Keywords: Thyroid; Thyroid nodule; Thyroid cyst; Ethanol; Sclerotherapy; Ablation
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