Mount Sinai surgeon performs radiofrequency ablation for thyroid nodules
August 26, 2019
(New York, NY – August 27, 2019) - Mount Sinai West has begun offering a minimally invasive procedure to treat non-cancerous thyroid nodules that are symptomatic and would have otherwise required invasive surgery for removal. The procedure is called radio-frequency ablation (RFA). It offers eligible patients a much quicker recovery, less pain and risk of infection, and no scarring.
Mount Sinai West is one of only two hospitals in New York State offering this procedure. Catherine Sinclair, MD, Associate Professor of Otolaryngology at the Icahn School of Medicine at Mount Sinai and Director of Head and Neck Surgery at Mount Sinai West, performed the first procedures the week of August 18.
“I am very excited to be able to perform this procedure, as I truly believe it will change the management of benign thyroid nodules and improve outcomes for a subset of patients with symptomatic, non-cancerous thyroid nodules,” says Dr. Sinclair. “It is wonderful that people who previously would have required partial or complete thyroid surgery now have an alternative which minimizes their risk of complications.”
With RFA, surgeons use guided ultrasound to deliver radio-frequency current to heat up and shrink the thyroid nodule. RFA can be done on patients with large non-cancerous nodules that cause swallowing, voice, breathing, and neck discomfort.
Patients who undergo RFA can return to normal activity the day after the procedure and can exercise within several days. Additionally, they are extremely unlikely to require permanent thyroid hormone medication. Patients who have standard thyroid nodule surgery typically can’t resume normal activity for at least a month and 20 to 30 percent of these patients require thyroid medication.
“Radiofrequency ablation for thyroid nodules has been performed in Korea for over a decade and throughout Europe and their outcomes are excellent. The published data shows impressive nodule shrinkage rates of more than 80 percent with RFA that is maintained over years of follow-up,” explained Dr. Sinclair. “Thyroid nodules are very common and, although many people will never require any intervention for their nodules, there is a significant minority who will seek treatment due to symptoms. I expect RFA to be a terrific new option for these patients.”
Mount Sinai West is the first and only hospital in the world using specialized and continuous laryngeal reflex monitoring during the radiofrequency ablation to prevent vocal cord damage and hoarseness, which are a potential risk during both RFA and standard surgery for thyroid nodule removal. Doctors stimulate nerve fibers to the voice box to prevent injuries. Typically, doctors monitor these nerves intermittently by stimulating them at various times through the procedure. But with intermittent monitoring, a possible nerve injury can be missed. Continuous stimulation allows doctors to see damage before it occurs and take preventive measures.
Mount Sinai West is the first and only hospital in the world using specialized and continuous laryngeal reflex monitoring during the radiofrequency ablation to prevent vocal cord damage and hoarseness, which are potential risks during both RFA and standard surgery for thyroid nodule removal. Doctors check nerve fiber function throughout the procedure and the continuous stimulation allows doctors to see damage before it occurs and take preventive measures. Typically, in open thyroid surgeries, doctors monitor these nerves intermittently by stimulating them at various times through the procedure. But with intermittent monitoring, a possible nerve injury can be missed. Continuous stimulation allows doctors to see damage before it occurs and take preventive measures. The method of continuous laryngeal monitoring developed and used by doctors at Mount Sinai is the only one that can be done without a neck incision and therefore is the only monitoring technique available for non-invasive procedures such as RFA.
Patients with large benign thyroid nodules that can be felt and that cause pain, difficulty swallowing, or difficulty breathing, are candidates for RFA. It is performed with the patients under general or local anesthesia.
About Mount Sinai Health System
The Mount Sinai Health System is New York City's largest integrated delivery system, encompassing eight hospitals, a leading medical school, and a vast network of ambulatory practices throughout the greater New York region. Mount Sinai's vision is to produce the safest care, the highest quality, the highest satisfaction, the best access and the best value of any health system in the nation. The Health System includes approximately 7,480 primary and specialty care physicians; 11 joint-venture ambulatory surgery centers; more than 410 ambulatory practices throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and 31 affiliated community health centers. The Icahn School of Medicine is one of three medical schools that have earned distinction by multiple indicators: ranked in the top 20 by U.S. News & World Report's "Best Medical Schools", aligned with a U.S. News & World Report's "Honor Roll" Hospital, No. 12 in the nation for National Institutes of Health funding, and among the top 10 most innovative research institutions as ranked by the journal Nature in its Nature Innovation Index. This reflects a special level of excellence in education, clinical practice, and research. The Mount Sinai Hospital is ranked No. 14 on U.S. News & World Report's "Honor Roll" of top U.S. hospitals; it is one of the nation's top 20 hospitals in Cardiology/Heart Surgery, Diabetes/Endocrinology, Gastroenterology/GI Surgery, Geriatrics, Gynecology, Nephrology, Neurology/Neurosurgery, and Orthopedics in the 2019-2020 "Best Hospitals" issue. Mount Sinai's Kravis Children's Hospital also is ranked nationally in five out of ten pediatric specialties by U.S. News & World Report. The New York Eye and Ear Infirmary of Mount Sinai is ranked 12th nationally for Ophthalmology and the South Nassau Communities Hospital is ranked 35th nationally for Urology. Mount Sinai Beth Israel, Mount Sinai St. Luke's, Mount Sinai West, and South Nassau Communities Hospital are ranked regionally.