Although benign tumors and nodules are not cancerous, they can be dangerous and should be removed. Radiofrequency Ablation (RFA) is a minimally invasive procedure that causes the thyroid nodules to shrink in size. Listen to this episode of the Texas ENT Specialists audio blog for more details.
Shelby Stockton: (00:00)
Welcome to the Texas ENT Audio blog. I'm your host, Shelby Stockton, and today I spoke with otolaryngologist Dr. Ryan Neilan about an exciting new nonsurgical treatment for the thyroid. Radiofrequency Ablation or RFA can reduce the size of thyroid nodules and restore thyroid function. Dr. Neilan explains the outpatient procedure and its benefits. If you deal with thyroid issues, this episode is for you.
Shelby Stockton: (00:27)
Dr. Neilan. You're a busy man and I really appreciate you joining me today.
Dr. Ryan Neilan: (00:32)
My pleasure. Thank you for having me.
Shelby Stockton: (00:33)
So we're here to discuss an exciting new non-surgical treatment for the thyroid. But before we get into that, could you explain to me and our listeners what is interventional endocrinology?
Dr. Ryan Neilan: (00:45)
And so traditionally, for approaches to disorders of the thyroid a lot of our treatment options have been surgical in nature, and so this is a way to treat some of these issues that have arisen and traditionally have been treated in a surgical fashion with a less invasive outpatient type approach.
Shelby Stockton: (01:10)
Okay, so there's a new procedure, everyone's talking about it. Can you tell us about this new procedure and what it does for the thyroid?
Dr. Ryan Neilan: (01:18)
And so patients that have either cosmetic or symptomatic nodules, whether they're having compression symptoms, trouble swallowing, trouble breathing, changes in their voice, sort of a lump in their throat type symptoms from that, now instead of a surgical approach for those patients, we're able to treat those with an electrode that emits a radiofrequency energy wave. And in doing so, creates some thermal energy and we use that heat to destroy the tissue that makes up the abnormal nodule in people's thyroids.
Shelby Stockton: (02:00)
Let me ask a question. Do these nodules happen because of genetics or is there lifestyle?
Dr. Ryan Neilan: (02:06)
No, they're actually really common. So probably about 50% of the adult population has one or multiple thyroid nodules. Most of these patients are in fact female. So there is some gender disposition in there. Of those nodules, probably about 90% are benign, and those are the ones that an approach like this would be trying to target for patients.
Shelby Stockton: (02:28)
Do we have any idea why thyroid issues happen with women more than men?
Dr. Ryan Neilan: (02:33)
No.
Shelby Stockton: (02:34)
Okay. I'm on TikTok and I see all these TikTok accounts of women talking about their thyroids. I'm like, I never see a man really talk about that issue. It's interesting.
Dr. Ryan Neilan: (02:45)
They're out there.
Shelby Stockton: (02:46)
It's out there. Okay. Yeah. Okay. So how does RFA, the shorter term-
Dr. Ryan Neilan: (02:54)
Version.
Shelby Stockton: (02:56)
Yes. Of thyroid nodules work?
Dr. Ryan Neilan: (02:59)
And so the needle is inserted into the actual nodule under ultrasound guidance, and once in place, we again apply this radio frequency energy wave through the tip of that needle that heats up the tissue to a temperature that actually destroys the cell that makes up that abnormal nodule. And then over a period of several months, the nodule itself sort of ablates or involutes over time.
Shelby Stockton: (03:27)
Is it a painful procedure?
Dr. Ryan Neilan: (03:30)
No, this is something that's done in the outpatient setting. We usually do apply some local anesthesia into the site directly, but people are awake and talking and swallowing the whole time, and really afterwards maybe take some Tylenol or Motrin and are resuming normal activity that next day.
Shelby Stockton: (03:52)
Wow. Okay. So what are the benefits of RFA of thyroid nodules?
Dr. Ryan Neilan: (03:57)
So the main one is probably no scar. So the previous surgical approaches leave a scar, the anterior portion of the neck, that again, with a lot of these patients being female, find cosmetically unappealing. So because this is done with the needle, there's no scar formation that there would be with the surgery.
Dr. Ryan Neilan: (04:17)
One of the other benefits is that with thyroid surgery, whether we're removing the whole thyroid or even just a portion of the thyroid, there can be a need for hormone replacement over the lifetime of the patient. With this approach, this is not something that those patients need, so we can preserve the normal function of the thyroid for them.
Dr. Ryan Neilan: (04:40)
The other issue is just a quicker recovery, as we kind of spoke about. These are patients that are back at work the next day without a hospital stay, and the recovery associated with the traditional approaches to this. Also just because of its minimal invasive nature, this is a procedure that has a much lower complication rate than traditional surgery as well.
Shelby Stockton: (05:02)
So how would someone know that maybe it's time to come see you because of their thyroid?
Dr. Ryan Neilan: (05:08)
Typically, these are patients that are having symptoms from their nodules. Again, a lot of people do have nodules. Most of them probably aren't going to be large enough, at least at that point in time to cause symptoms they do tend to grow over time. And so again, these are patients that either having cosmetic issues where when they look in the mirror they can actually see the silhouette of their thyroid, so it's apparent to them. These are also patients that are having pressure symptoms in the neck, difficulty swallowing, shortness of breath.
Shelby Stockton: (05:38)
Great. Well, Dr. Neilan, thank you so much for spending some time with us today. I know you're a busy guy, but we really appreciate it.
Dr. Ryan Neilan: (05:45)
Thank you. My pleasure.
