1. This article explains the need for standby ice cold 5% dextrose during RFA treatments for thyroid nodules and cancer.
2. Aborting the treatment at the first sign of voice change and injection of dextrose can reverse the abnormal voice change rapidly.
3. Add iced dextrose to your RFA set up tray.
5. Contact me at 310-393-8860 or [email protected]
Effectiveness of Injecting Cold 5% Dextrose into Patients with Nerve Damage Symptoms during Thyroid Radiofrequency Ablation.
Min Kyoung Lee1,2, Jung Hwan Baek1, Sae Rom Chung1, Young Jun Choi1, Yu-Mi Lee3, Tae Yong Kim4, Jeong Hyun Lee
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.