Safety and efficacy of ethanol ablation for benign thyroid cystic nodules: A single centre experience

Objective: To evaluate and audit the safety and efficacy of ultrasound guided ethanol ablation for the treatment of benign thyroid cystic nodules with pressure and cosmetic symptoms. Methods: Retrospective case series from November 2018 to March 2021 with patients presented with symptomatic benign cystic thyroid nodules and treated with ethanol ablation. The major clinical outcomes were 6-month volume reduction rate and improvement in pressure symptom score and cosmetic symptom score. All complications were evaluated. Results: We studied thirty-seven consecutive cases with symptomatic benign thyroid cystic nodules. All cystic nodules were confirmed by FNAC to be benign. Seven out of thirty-seven cases received two sessions of ethanol ablation. The initial mean volume of cystic nodules was 17.93 ml (range 1.11 ml-60.01 ml). The mean volume of ethanol injected was 3.54 ml (range 0.5 ml-10.0 ml). The mean volume at 6-month post ablation was 4.48 ml (range 0 ml-60.15 ml). The mean volume reduction rate at 6-month post ablation was 80.46%. The median procedure time was 15 minutes. Adverse events were noted in three cases including transient pain and haematoma. The mean pressure symptom score improved from 4.48 (pre-ablation)(range 0-10) to 1.20 (post-ablation)(range 0-5). The mean cosmetic symptom score improved from 3.45 (pre-ablation) (range 1-4) to 1.37 (post-ablation)(range 1-3). There was one case with salvage hemithyroidectomy arranged. Conclusion: Ultrasound guided ethanol ablation is a safe and feasible treatment for symptomatic benign thyroid cystic nodules in terms of volume reduction and symptomatic relief, it serves as an alternative to surgical resection.