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
