Prevalence and Management of Complications of Laser Ablation for Benign Thyroid Nodules
By
Lorenzo Scappaticcio
Nicole Di Martino
Pamela Ferrazzano
Maria Ida Maiorino
Paola Caruso
Alessandra Volatile
Miriam Longo
Giovanni Docimo
Eduardo Iervolino
Pierpaolo Trimboli
Katherine Esposito
Giuseppe Bellastella
February 20, 2025
Clinical Scorecard: Incidence and Treatment of Complications Associated with Laser Ablation for Noncystic Benign Thyroid Nodules
At a Glance
Category Detail
Condition Benign solid (noncystic) thyroid nodules Key Mechanisms Ultrasound-guided percutaneous laser ablation causing thermal tissue destruction Target Population Patients with symptomatic, cytologically benign solid thyroid nodules Care Setting Outpatient or hospital settings performing minimally invasive thyroid nodule treatments
Key Highlights
Overall complication rate of laser ablation (LA) is 23%, with minor complications at 21% and major complications at 2%. Local pain is the most common minor complication (15%), typically transient and mild to moderate in severity. Dysphonia occurs in 2% of cases, mostly transient with rare permanent cases; higher prevalence noted with local anesthesia or conscious sedation. Guideline-Based Recommendations
Diagnosis
Confirm cytologically benign status of thyroid nodules before LA using ultrasound and fine-needle aspiration. Management
Use ultrasound guidance for precise laser fiber placement during ablation. Manage local pain with analgesics for 1 to 5 days up to 1 month as needed. Monitor and manage dysphonia symptoms; most cases resolve spontaneously. Monitoring & Follow-up
Monitor patients post-procedure for signs of complications including pain and voice changes. Follow-up ultrasound to assess volume reduction and detect any adverse effects. Risks
Minor complications such as local pain and transient dysphonia are common but generally manageable. Major complications are rare but require prompt recognition and management. Patient & Prescribing Data
Patients with symptomatic benign solid thyroid nodules undergoing laser ablation
Laser ablation is a safe and cost-effective alternative to surgery with a low rate of major complications and manageable minor side effects.
Clinical Best Practices
Perform thorough pre-procedural evaluation to confirm benign nature of nodules. Apply real-time ultrasound guidance to optimize laser fiber placement and minimize complications. Use local anesthesia or conscious sedation cautiously, considering their association with increased dysphonia risk. Provide adequate analgesic treatment post-procedure to manage local pain. Educate patients about the transient nature of most side effects and the rarity of permanent complications. References
