Protective effect of modified fluid isolation on the recurrent laryngeal nerve in ablative treatment of thyroid nodules.

Abstract

Background: Real-time ultrasound-guided radiofrequency ablation (RFA) is a widely used technique for the treatment of thyroid nodules. Liquid isolation methods are often employed frequently utilized to augment the safety of RFA. However, recurrent laryngeal nerve injury (RLN) has still been reported in clinical practice. We developed a modified liquid isolation method to reduce the occurrence of RLN injury. This study aims to evaluate the protective effect of the modified isolation technique on the RLN during thermal ablation of thyroid nodules.

Methods: This study included patients who underwent RFA with a liquid isolation method. Patients were divided into two groups according to the liquid isolation technique: modified or traditional. Univariate and multivariate logistic regression analyses were further performed to evaluate whether the type of liquid isolation method had an impact on the occurrence of RLN injury.

Results: A total of 196 patients were included in the study. Hoarseness occurred in 2 cases (2.2%) in the modified liquid isolation group, compared with 10 cases (9.4%) in the traditional liquid isolation group (p = 0.036). Patients in the modified group had a higher proportion with a history of thyroid surgery. Further multivariate regression analysis indicated that the modified liquid isolation technique was associated with a significantly lower risk of RLN injury (OR: 0.18; 95% CI: 0.04-0.89; p = 0.036).

Conclusion: The modified liquid isolation method has a better protective effect on RLN in the ablative treatment of thyroid nodules.