Laser ablation
What is laser ablation?
Laser ablation is a minimally invasive procedure that can be used to reduce the size of benign symptomatic thyroid nodules. Laser ablation uses light energy to cause heat-induced damage to the cells of the treated nodule, resulting in a decrease in nodule size. Significant pain during a laser ablation is unusual and can usually be managed by adjusting the administered energy or applying more numbing medication.
How effective is laser ablation?
Laser ablation may be somewhat less effective than RFA, but it can still be used to successfully treat thyroid nodules. A summary of data from 7 different studies showed that on average, laser ablation produced a 52.3% volume reduction at 12 months and a 45.9% reduction at 36 months however a total of 21.4% of patients later required thyroid surgery because of regrowth, persistent cosmetic concerns, or compressive symptoms. Though evidence suggests that RFA is superior to laser ablation in terms of nodule volume reduction and durability of the treatment response, in the hands of an expert, laser ablation can still be very effective.
How is laser ablation performed?
Laser ablation is an outpatient procedure performed under local anesthesia. You will be awake during the procedure though your doctor may recommend a medication like Xanax to help you relax. One or sometimes several needles are inserted into the targeted thyroid nodule using an ultrasound to be sure the needles are in the correct location. Very thin optical fibers are threaded through the needle and connected to a laser light source. The optical fiber is then slowly moved through the target. The energy delivered from the laser causes heat-induced damage to the nodule, effectively causing the cells in the nodule to die. The procedure takes approximately 30 to 45 minutes.
What is the recovery like?
Recovery is usually rapid after laser ablation. Your doctor may recommend ice, anti-inflammatories, and sometimes a small dose of a steroid to decrease inflammation and swelling. As an advantage over traditional surgical treatment, the needle punctures required for the treatment heal quickly making laser ablation effectively scarless. Patients can return to normal activities within 24 hours. Follow-up usually involves a post-procedure office visit and neck ultrasound at 1, 6, and 12 months following treatment. Follow-up visits help your doctor determine how much the nodule has decreased in size and whether your initial treatment was been sufficient.
