Effect of Ultrasound-Guided Ethanol Ablation in Management of Benign Cystic Thyroid Nodules

Background: Thyroid swellings are common in daily medical practice. Surgery was the standard curative treatment. However, the higher complications of surgery induced the search for alternative safe and effective options. Ethanol ablation under ultrasound guidance was introduced and considered a convenient alternative. However, no consensus yet was reached regarding the optimal treatment option. The aim of the work: Evaluating the value of ultrasound guided ethanol ablation in the treatment of benign cystic thyroid nodules. Patients and Methods: One hundred patients with cystic thyroid swelling were included. Patient evaluation was performed by careful history taking, clinical examination, laboratory investigations and ultrasound examination. Then drainage of the cyst followed by ethanol ablation was performed and outcome was assessed directly after the intervention, after 1 and 3 months. The reduction of cystic volume was recorded and any complications were documented. Results: The majority of patients were females [78.0%] and compressive symptoms were the commonest presentation [95.0%]. The purely cystic nodules represented the highest nature [70.0%] followed by the septated cystic [20.0%] and predominantly cystic [10.0%]. The volume of injected ethanol ranged from 3 to 10 CC. By ultrasound, there was significant reduction of the nodule volume, and significant increase of VRR % after one month than the basal values and at three months than the first month in all patients. At the end of the third month, the volume reduction rate showed significant increase in the purely cystic than the predominantly cystic nodules [80.0- 97.2% vs 56.8 – 90.0%, respectively]. The complications during the procedure was reported in 4 cases in the form of acute severe cervical pain. After the intervention, 7 patients reported mild neck pain. Conclusion: Ethanol ablation is an effective and safe procedures for cystic and predominantly cystic benign thyroid nodules on the short term follow up.