RFA – Procedure
The “black tunnel” in the middle of the cartoon to the left is the trachea with the horseshoe-shaped thyroid gland wrapped around it. The “serrated sleeve” behind it is the oesophagus. The yellow lines mark the areas that are treated with a local anaesthetic. The needle tip heats up a small portion of the surrounding tissue, allowing the nodule or cyst to be treated bit-by-bit.
The tip of the applicator has a diameter of only 1-2 mm and is inserted after a tiny incision of the skin under ultrasound guidance. Only a few mm of nodule tissue surrounding the tip is being treated at a time before the applicator is moved to another position. The nodule is then treated level by level until the lower pole is reached.
During the entire procedure you remain fully conscious, are allowed to breath and swallow in a normal way. We monitor your ECG, pulse rate, blood pressure and oxygen level throughout the intervention. If you feel like you can watch TV.
Follow-up after RFA
We ask our patients not to drive home by car by themselves and to come with an accompanying person. Following RFA we ask you to stay for another 30 min with us. While you drink a cup of tee or coffee you will gently press an ice-pack on your neck.
We usually perform follow-up visits at 3 and 12 months. If you want to or come from abroad you may also have your control visit at your local thyroid specialist.
It is important to know for your thyroid specialist that the treated nodule looks considerably different to before RFA. The nodule shrinks because the treated cells get removed and some connective (scar) tissue forms. At ultrasound examinations it not only changes its size considerably but also its “color” and “texture”. Sometimes there are also tiny microcalcifications to see. All this may lead to uncertainty of your thyroid doctor so it is a good idea to bring our RFA report with you for these follow-up visits.