#Radiofrequency #Ablation #Fashionable #Administration #Thyroid #Nodules #David #Goldenberg #ENT
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On this episode of BackTable ENT, Dr. Gopi Shah and Dr. David Goldenberg, head and neck surgeon and division chair at PennState Well being in Pennsylvania, talk about radiofrequency ablation (RFA) of thyroid nodules.
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SHOW NOTES
First, Gopi and David assessment workup of thyroid nodules. Earlier than contemplating RFA, sufferers want thyroid operate checks, ultrasound imaging, and a biopsy displaying benign illness. In David’s opinion, radiofrequency ablation is an effective choice for benign nodules bigger than two centimeters which might be enlarging and inflicting compressive signs. RFA shouldn’t be acceptable for malignant illness, with the potential software for papillary microcarcinoma, which is presently being evaluated in different elements of the world.
Subsequent, David outlines how he performs RFA. Utilizing a mixture of gentle sedation, native anesthesia, and regional anesthesia, he performs this process in-office below steady ultrasound steerage. Radiofrequency ablation makes use of warmth to trigger coagulative necrosis of nodular tissue. After cervical block and anesthetization of the thyroid capsule, David introduces the RFA probe by way of a small midline neck incision. Drawing on the “transferring shock method,” he strikes the RFA probe backwards and forwards, awaiting indicators of tissue necrosis on ultrasound. Problems of RFA are just like these of thyroid surgical procedure, however they happen at decrease charges as a result of much less invasive nature of this process.
Lastly, the dialog locations RFA in a bigger context for the thyroid surgeon. RFA sufferers return to the clinic that very same week for a bodily examination. Surveillance ultrasounds happen six and twelve months post-procedure. David counsels his sufferers that their nodule won’t shrink instantly, and should swell within the days following their process. Nevertheless, he expects the nodule to shrink 50-80% within the 12 months following RFA. The podcast wraps up with an outline of easy methods to carry RFA to your apply.
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RESOURCES
David’s Penn State Profile:
https://www.pennstatehealth.org/medical doctors/david-goldenberg-md-facs
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The BackTable ENT Podcast is a useful resource for otolaryngologists to be taught suggestions, methods, and sensible recommendation on all issues ear, nostril, and throat. Tune in to the BackTable ENT Podcast each week for candid conversations about rhinology, laryngology, otology, and head and neck surgical procedure.
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