Microwave Ablation versus Combined Ethanol–Microwave Ablation in Symptomatic Benign Thyroid Nodules: A Single-Center Comparative Study

Aim: To compare the efficacy and safety of ultrasound-guided microwave ablation (MWA) and combined ethanol plus microwave ablation (EA+MWA) in patients with symptomatic benign thyroid nodules.Materials and Methods: This retrospective study included 24 patients (25 nodules) treated between January 2023 and January 2025. Patients with predominantly solid nodules underwent MWA (n = 18), while patients with nodules with prominent cystic components received EA+MWA (n = 6). Nodule volumes were calculated using the ellipsoid formula before and 6 months after the procedure, and the volume reduction ratio (VRR%) was determined.Results: The mean VRR at 6 months was 62.15% ± 9.61 in the MWA group and 74.37% ± 14.27 in the EA+MWA group. Although higher in the EA+MWA group, the difference did not reach statistical significance (p = 0.094). Both groups demonstrated substantial volume reduction and were free from major complications. Transient hoarseness occurred in four patients.Conclusion: Both MWA and EA+MWA are effective and safe for the treatment of symptomatic benign thyroid nodules. The combination of EA and MWA may provide greater volume reduction in nodules with prominent cystic components.