Protecting the nerves during RFA and thyroid surgery

Protecting the nerves during RFA and thyroid surgery

During this interview, the following topics are discussed:

→ Stanford University prioritizes anatomic structures, ultrasound, and how to best protect the laryngeal nerve

→ Pre- procedure ultrasound is instrumental in minimizing risk

→ Risk to the laryngeal nerve is minimal during RFA

→ Where to deliver heat is guided by ultrasound

→ If unintended consequences occurs during RFA, they are usually reversible

→ Most risk is affecting a patient’s voice

→ Technique and space — away from structures — can be controlled with extra fluid

→ Dr. Noel has conducted 80+ RFA procedures at Stanford University

→ What should every practitioner know in regard to protecting the nerves?

→ Commitment to ultrasound anatomy is critical

→ Ultrasound guided procedures

→ The Stanford RFA team for conducting a procedure is one assistant MD or Fellow, medical assistant laying out equipment and vital signs

→ Patient due diligence when selecting an RFA doctor is key: it should include vetting providers for their experience with RFA

→ Ask if the doctor has done RFA procedures, what’s the plan for follow up?

→ With RFA, are fewer thyroidectomies occurring?With RFA in clinic, patients now have more treatment options

→ “No hammers looking for nails”

→ Who is the ideal candidate for RFA?

→ Solitary, large, benign thyroid nodule is the ideal candidate

→ Cost is between $5000 – $10,000

→ Reduction in thyroid nodule size is up to 80%RFA can be used for malignant nodules

→ Why did it take so long for the U.S. to adopt RFA?FDA processes are laborious and time consuming

→ Is RFA painful? Generally “no”

→ RFA fills a void in treatment options for thyroid nodule

→ Preservation of thyroid function is key — the thyroid is preserved

→ Does insurance cover RFA treatment?

→ Sometimes the insurance company will cover the procedure through an appeal process