Thyroid disorders affect more than 12% of Americans. Despite the prevalence of thyroid diseases, up to 60% of those affected may be unaware of their condition. Women are five to eight times more likely than men to experience thyroid problems, with one in eight women developing a thyroid disorder during their lifetime.
The thyroid gland regulates metabolism, controls body temperature, and manages heart and nervous system function. Thyroid dysfunction can lead to weight fluctuations, sleep issues, cognitive impairment, and changes in menstrual patterns.
For individuals undergoing a thyroid radiofrequency ablation (RFA) procedure, knowing what to expect after radiofrequency ablation can help alleviate concerns and ensure a smoother healing journey.
Why is Radiofrequency Ablation Procedure Performed?
Thyroid radiofrequency ablation (RFA) is a minimally invasive and effective procedure for treating certain thyroid nodules and conditions. Unlike traditional surgical methods, RFA offers a targeted approach to shrinking thyroid nodules using thermal energy. This innovative procedure reduces the potential risks and prolonged recovery associated with surgery.
Some of the reasons your doctor may prescribe thyroid RFA include the following:
- Non-surgical alternative: RFA is an excellent option for patients who are unsuitable for surgery or prefer to avoid it due to underlying health conditions or surgical risks.
- Nodule reduction: The primary goal of RFA is to reduce the size of benign thyroid nodules, alleviating potential symptoms like difficulty swallowing, breathing, or cosmetic concerns.
- Pain management: For patients experiencing discomfort or pain related to thyroid nodules, RFA can offer relief by targeting and shrinking the nodules responsible for the symptoms.
- Preservation of thyroid function: Unlike surgery, which may involve removing a portion of the thyroid, RFA preserves thyroid function, minimizing the risk of hypothyroidism and the need for life-long medication.
- Outpatient procedure: RFA is typically an outpatient procedure, allowing patients to return home the same day with a faster recovery time compared to surgery.
- Minimal scarring: The procedure requires only a small incision, resulting in minimal scarring and improved cosmetic outcomes.
- Less downtime: Patients can generally resume their daily activities within a few days after RFA, contributing to a quicker return to normalcy.
The Step-by-Step Process of Radiofrequency Ablation
Thyroid radiofrequency ablation (RFA) uses alternating electric currents to generate thermal tissue damage and fibrosis, leading to the shrinkage of the targeted nodules.
It offers patients an effective alternative to traditional surgery because it uses a precise approach without compromising healthy thyroid tissue. The following step-by-step process of thyroid radiofrequency ablation demonstrates how it provides a safe and efficient solution for managing certain thyroid conditions.
- Patient preparation: The patient lies on an exam table, with their head and neck supported by a pillow. Grounding pads are placed on the thighs to ensure a safe return path for the radiofrequency waves.
- Local anesthesia: The doctor administers local anesthesia to numb the area surrounding the thyroid gland, ensuring the patient’s comfort throughout the procedure. Some patients may receive mild sedation to promote relaxation.
- Ultrasound guidance: An ultrasound machine and transducer precisely locate the thyroid gland and the targeted nodule.
- Needle insertion: A thin needle is carefully inserted with an insulated wire inside. The electrode is connected to ground pads on the patient’s legs.
- RF generator activation: Once the needle is in place, the radiofrequency generator is activated, sending alternating electrical currents to the needle tip. The resulting ionic friction generated produces heat within the nodule up to 141°F.
- Moving shot technique: To prevent tissue overheating, the electrode is continually moved inside the thyroid gland using a moving shot technique. This ensures thorough ablation of the entire nodule, leading to the death of most or all of its cells.
What to Expect After Radiofrequency Ablation: Immediately After Treatment
Thyroid RFA offers a faster recovery time compared to surgery. Following the procedure, you may experience slight swelling at the needle insertion site and bruising or mild discomfort, which can be managed with over-the-counter pain medications. These issues should subside within two to three days after treatment.
As thyroid RFA is typically an outpatient procedure, it’s essential to organize for someone to drive you home afterward, especially if you received sedation. You may need to stay at the clinic for several hours while the effects of the medication wear off.
You should be able to resume normal activities and return to work the following day.
Over the next several months, you will notice a reduction in the size of the nodules. A study from 2021 found that patients experienced a 50% nodule volume reduction in the six months following treatment. However, the rate of size reduction depends on the original nodule size; larger nodules typically take longer to shrink than those smaller than 5 ml.
What to Expect After Radiofrequency Ablation: Post-Procedure Care at Home
After undergoing thyroid radiofrequency ablation (RFA), following the prescribed post-procedure care is essential for a smooth recovery and optimal outcomes, including:
- Pain management: If you experience any discomfort or pain after the procedure, over-the-counter pain management medications can help alleviate it.Avoid taking aspirin or other blood-thinning medications unless your healthcare provider advises, as they can increase the risk of bleeding at the needle insertion site. Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) that inhibits platelet function, which is essential for blood clotting.
- Restrictions on activity: While thyroid RFA has a faster recovery time than surgery, it’s still essential to avoid strenuous activities, heavy lifting, and vigorous exercise for a few days after the procedure. This helps promote proper healing and minimize the risk of complications, such as hematoma development.
- Lifestyle adjustments: Maintaining a healthy lifestyle, including a balanced diet and adequate rest, can support your recovery. Stay hydrated and avoid smoking or excessive alcohol consumption.
- Follow-up appointments and check-ups: Regular follow-up appointments at 6-8 weeks, 6 months, and 12 months are crucial to monitor your progress after RFA. During these visits, your healthcare provider will assess your recovery, check thyroid function, and ensure the nodules are shrinking as expected.
Risks Associated with Radiofrequency Ablation
Thyroid RFA is a well-tolerated treatment with a low risk of serious complications and long-term side effects. Most reported side effects are short-term and resolve within one to two weeks. Some side effects associated with thyroid ablation include:
- Pain or discomfort during the procedure: Most patients receive a local anesthetic at the electrode injection site, minimizing pain and discomfort. Only 2% to 3% of patients may experience discomfort, which can be resolved with increased local anesthetic dosage.
- Voice change: Temporary or permanent voice changes are rare, with 0.94% reporting a temporary change and 0.17% reporting a permanent change.
- Nausea or vomiting: A small number of patients may experience nausea or vomiting, usually occurring after the procedure due to neck extension. Recovery from this side effect typically takes one to two days.
- Nodule rupture: Nodule rupture is uncommon, reported in only 0.17% of patients during RFA treatment. Proper training and ultrasound guidance by a skilled physician can reduce the risk of nodule rupture.
- Slow heart rate or faintness: Some patients may experience faintness or a slowed heart rate due to Vagus nerve stimulation during RFA. This side effect is rare and fades after the procedure.
- Hematoma: Hematomas, caused by damage to blood vessels near the skin’s surface, are rare and typically disappear within two weeks.
- Nerve damage: While nerve damage is extremely rare, the dense bundling of nerves in the neck poses a slight risk. Advanced techniques, such as the trans-ischemic approach and moving shot method, are employed to minimize this risk.
- Hypothyroidism: Permanent hypothyroidism due to RFA is extremely rare. Regular check-ups after the procedure help monitor thyroid function and reduce the risk of developing hypothyroidism.
- Infection: Infections and abscesses are rare due to the small size of the electrode tip and sterile procedures during RFA.
- Transient thyrotoxicosis: Excessive thyroid hormone levels, known as thyrotoxicosis, can occur due to nodule rupture, but patients typically recover spontaneously within 30 days.
Long-Term Outlook After Radiofrequency Ablation
Thyroid RFA has a high short-term success rate. A 2021 study demonstrated that benign thyroid nodules showed a 64.72% reduction after three months and an overall therapeutic success rate of 84.6%. However, benign thyroid nodules can grow back.
For patients who do not achieve the desired nodule reduction outcomes with a single RFA session, additional treatments could be a viable option to enhance long-term benefits and improve thyroid health.
A 2022 study analyzed electronic medical records of patients who underwent RFA for cosmetic or symptomatic issues related to thyroid nodules. The nodules were divided into three groups: group one received additional treatment, group two met the criteria but did not receive further treatment, and group three did not meet the criteria.
After a follow-up of at least 30 months, group one showed significant reductions in nodule volume and larger volume reduction ratios (VRR) compared to group two. Multiple treatment sessions resulted in higher VRR.
Visiting your doctor for regular follow-up and monitoring after each session will be crucial to assess the progress and tailor the treatment approach for optimal results.
Enjoy a Better Quality of Life After Radiofrequency Ablation
If you experience symptoms of thyroid dysfunction, book an appointment with Associated Endocrinologists. Our board-certified physicians can diagnose and treat your thyroid condition with thyroid ultrasound, thyroid RFA, and thyroid biopsies and help you understand what to expect after radiofrequency ablation.