The study included 1531 patients who underwent laser ablation for 1534 nodules. A total of 83% of the nodules were treated with a single session of laser ablation, 13% required two sessions and 3% required 3 sessions. The average reduction in nodule volume at 12 months was 72%. There were no changes in thyroid function at 12 months. Local symptoms attributed to the nodules generally improved, as did the cosmetic appearance.
There were 17 complications, 8 major and 9 minor; none were life-threatening. A total of 8 patients had voice changes immediately after the session and laryngoscopy showed the vocal-cords not working correctly. All were treated with steroids and recovered completely. The minor complications included bruising and skin burns. About 30% of patients experienced pain, often radiating to the jaw or shoulder that disappeared when the laser was turned off. Persistent moderate or severe pain was reported in about 2%; this disappeared within 3 days. A total of 12 patients (0.7%) fainted and 141 patients (3.3%) had fever that lasted up to 3 days.
According to this study, laser ablation therapy of benign nodules is effective, reproducible, and generally well tolerated and has a low risk of major complications.
WHAT ARE THE IMPLICATIONS OF THIS STUDY?
This is an interesting technique that is not widely used in the United States. It is important that the centers reporting their data all had at least 2 years of experience with the procedure, which probably contributed to the low number of complications reported. The major complication was temporary vocal-cord paralysis in almost 1% of patients. Also 1 in 3 patients experienced pain with the procedure. Depending on the cost associated with the technique and whether it is easy for physicians to perform, this could potentially become a more common treatment option for benign thyroid nodules.
— Ronald B. Kuppersmith, MD, FACS
ATA THYROID BROCHURE LINKS
Thyroid Nodules: http://www.thyroid.org/thyroid-nodules/