Safety and efficacy of ethanol ablation for benign thyroid cystic nodules: A single centre experience

Abstract

Objective To evaluate and audit the safety and efficacy of ultrasound guided ethanol ablation for the treatment of benign thyroid cystic nodules with pressure and cosmetic symptoms. Methods Retrospective case series from November 2018 to March 2021, presented with symptomatic benign cystic thyroid nodules and treated with ethanol ablation. The major clinical outcomes were 6-month volume reduction rate and improvement in pressure symptom scores and cosmetic symptom score. All complications were evaluated. Results We studied thirty-seven consecutive cases with symptomatic benign thyroid cystic nodules. All cystic nodules were confirmed by FNAC to be benign. Seven out of thirty-seven cases received two sessions of ethanol ablation. The initial mean volume of cystic nodules was 17.93ml (range 1.11ml- 60.01ml). The mean volume of ethanol injected was 3.54ml (range 0.5ml-10.0ml). The mean volume at 6-month post ablation was 4.48ml (range 0ml- 60.15ml). The mean volume reduction rate at 6-month post ablation was 80.46%. The median procedure time was 15 minutes. Adverse events were noted in three cases including transient pain and haematoma. The mean pressure symptom score improved from 4.48 (pre-ablation)(range 0-10) to 1.20 (post-ablation)(range 0-5). The mean cosmetic symptomscores improved from 3.45 (pre-ablation) (range 1-4) to 1.37 (post-ablation)(range 1-3). There was one case with salvage hemithyroidectomy arranged. Conclusion Ultrasound guided ethanol ablation is a safe and feasible treatment for symptomatic benign thyroid cystic nodules in terms of volume reduction and symptomatic relief, it serves as an alternative to surgical resection.