Minimally invasive ablation techniques for thyroid nodules

Czech version

Authors: T. Grimmichová ^1,2; J. Hrdlička ³; J. Jiskra⁴; D. Reva⁵; J. Vodička⁵; B. Bendlová ¹
Authors‘ workplace: Endokrinologický ústav, Praha ¹; Interní klinika a 3. LF UK a FN Královské Vinohrady, Praha ²; Radiodiagnostická klinika 1. LF UK a VFN v Praze, ⁴ III. interní klinika – klinika endokrinologie a metabolismu 1. LF UK a VFN v Praze, ⁵ Klinika otorinolaryngologie a chirurgie hlavy a krku, Nemocnice Pardubického kraje, Nemocnice Pardubice ³
Published in: Otorinolaryngol Foniatr, 75, 2026, No. 3, pp. 216-221.
Category: Review Article
doi: https://doi.org/10.48095/ccorl2026216

Overview

This review article is dedicated to minimally invasive ablation techniques for thyroid nodules, which are a globally recommended alternative to traditional surgical procedures for certain patients. The principle of ablation techniques is to induce coagulative necrosis in the tissue either chemically (by administering ethanol) or thermally (RFA –⁠ radiofrequency; MWA –⁠ microwave ablation). Percutaneous ethanol ablation is indicated for symptomatic, relapsing cystic nodules. Thermal ablations (RFA, MWA) are indicated for symptomatic benign, mixed cystic-solid and solid nodules and low-risk papillary carcinomas up to 2 cm in size. In the hands of an experienced surgeon, these are less invasive than common surgical procedures. A successful ablation procedure for a benign thyroid nodule is considered to be a volume reduction of more than 50% with improvement in mechanical or cosmetic symptoms. The goal for malignant tumors is complete destruction with a safe margin of surrounding tissue. The most common complications include bleeding, pain, and swelling. A serious but rare complication is thermal injury to critical structures in the neck; most often, this involves injury to the recurrent laryngeal nerve with transient dysphonia. The procedure is performed under local anesthesia, there is no scar, and there is no need for thyroid hormone replacement therapy.

Keywords:

thermal ablation – thyroid nodule – ethanol ablation – papillary microcarcinoma

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