Focused Ultrasound HIFU Like Other Ablation Systems Needs to Stay Clear of the Danger Triangle Where the Vocal Cord Nerve are Located. e

Focused Ultrasound HIFU Like Other Ablation Systems Needs to Stay Clear of the Danger Triangle Where the Vocal Cord Nerve are Located. e

 

Focused Ultrasound HIFU Like Other Ablation Systems Needs to Stay Clear of the Danger Triangle Where the Vocal Cord Nerve are Located
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This image from a differenteerent  has the red danger triangle where the recurrent nerve is located. The arrow is the location of the vagus nerve.
Vocal cord paresis following single-session high intensity focused ablation (HIFU) treatment of benign thyroid nodules – incidence and risk factors.
Lang BH et al Int J Hyperthermia. 2017 May 24:1-27.

BACKGROUND:

Vocal cord paresis (VCP) may occur following high intensity focused ultrasound (HIFU) of thyroid nodules.

METHODS:

103 patients who underwent HIFU for symptomatic benign thyroid nodules. The distance from the Focus Point FP where the heat was delivered to the danger triangle where the recurrent nerve is located was measured.

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The Focus Point is where the two US beams meet.

RESULTS:

4/103 (3.9%) patients suffered a vocal cord paralysis. They all recovered fully within 6 weeks.. The distance from the danger triangle was the only significant factor.

CONCLUSIONS:

The distance between the Focus Point FP and the danger triangle was the only related factor. The safe distance should be ≥1.1cm.

Comments: The use of HIFU is safe and can be an alternative to surgery in the hands of expert interventional thyroid ablation physicians. Temporary not permanent vocal cord malfunction was seen in only 4 patients. We do not have HIFU for thyroid nodules in the USA at present. We are sending patients who do not want surgery to Europe or Asia for HIFU. HIFU ids the ony trult non-invasive method because the probe sits on the neck over the nodule not inside the nodule as in ethanol, radiofrequency, and microwave.Call Matt at 310-393-8860

The HIFU system is made in France and is sold all over the world as ECHOPULSE.

Richard Guttler MD,FACE,ECNU

thyroid.com

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