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Innovations 2021

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for Thyroid Nodules BY CARI WADE GERVIN PENN STATE HE ALTH NOW OFFERS ADVANCED TRE ATMENT FOR THYROID NODULES. THYROID NODULES ARE quite common as people age, especially in women. The over whelming majority of nodules — around 19 out of 20 — are benign, and usually a simple ultrasound can determine if a nodule shows signs that it could be cancerous and may require a biopsy. Most benign thyroid nodules never require clinica l inter vention because the nodu les cause no sy mptoms a nd never increase in size. In fact, patients may never present with a complaint. But for some patients, the size or number of nodules can be disturbing. "Occa sion a l ly, nodu les w i l l h ave grown so large that they put pressure on surrounding structures, such as the trachea or the esophagus, because both of those structures are close to the thyroid gland," says David Goldenberg, MD, FACS, professor and chair of the Department of Otolaryngology – Head and Neck Surgery at Penn State Health Milton S. Hershey Medical Center. "Sometimes a person will just have a thyroid nodule that is so large, it protrudes out through the neck, and from a cosmetic standpoint, the person doesn't like the way it looks." RFA: A MAJOR ADVANCE IN TREATMENT Unti l recent ly, troublesome nodu les of ten required surger y to remove a part or a ll of the thyroid gland. However, sur- ger y of the thyroid is not devoid of risk, including da mage to the ner ves to the voca l cords and the parathyroid glands. Dr. Goldenberg now offers radiofre- quency ablation (RFA) for treatment of thyroid nodules, along with some goiters and small tumors. RFA is a minimally i nva sive a lter native to surger y a nd requires only local anesthetic. "During the procedure, local anesthetic is used. Then a small needle electrode is inserted into a thyroid nodule under ultrasonic guidance," Dr. Goldenberg says. "While I hold the ultrasound probe, heat is generated at the tip of the needle while it is inside the thyroid nodule, and it destroys the targeted tissue. Then, over the next few weeks, the body absorbs the destroyed tissue, and the nodule involutes and shrinks." Most patients experience only mild b r u i s i n g a n d n o s c a r r i n g . R FA i s contra indicated in patients who a re preg na nt, have a ca rdiac pacema ker or have nodules located nea r cer ta in critica l structures. AVAILABLE LOCALLY ONLY AT HERSHEY MEDICAL CENTER Dr. Goldenberg bega n performing R FA for thyroid nodules in 2020. Currently, the Milton S. Hershey Medica l Center i s t he on ly hospit a l i n t he reg ion t o of fe r t h e t r e a t m e nt . Ho w e v e r, t h e o t ol a r y n golo g y t e a m i s c a r e f u l t o a ssess which patients wou ld benef it most f rom R FA a nd t hose who need traditiona l surger y. " I ' v e b e e n p e r f o r m i n g t h y r o i d s u r ger y for a ver y lon g t i me , a nd I a m ver y cautious about ma king sure t hat a patient doesn't have a t hy roid cancer before offering R FA treatment," Dr. Goldenberg says. "My practice offers patients options from obser vation to surger y to radiofrequency ablation. If a physician is concerned about a patient 's possible thyroid nodules, I a m happy to discuss a ll the options. Ultimately, the decision to choose obser vation or R FA is that of the patient." n Find out if RFA is right for your patients at pennstatehealth.org/rfa or by calling the otolaryngology clinic at 717-531-6822. Radiofrequency Ablation 0 8❱❱❱❱❱ C O V E R F E A T U R E

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