If there is <10% solid component ethanol ablation is the treatment of choice. 10-50% solid component a combination of PEI and RFA is the preferred therapy. >50% solid thyroid RFA is the preferred therapy. PEI 10% solid nodules 85-95 volume...More info
What Are the Indications to Treat Local Recurrent Papillary thyroid Cancer?
For attempted curative RFA therapy 2.The number of abnormal cancer lymph nodes has to be limited to 3-4. 3.There must not be metastatic disease outside the neck. 4. The size of the lymph nodes to be RFA treated must be less than 1.5-2 cm. 1.. For...More info
Pearls for Thyroidologists about RFA for their Patients.
RFA is a game changer for your thyroid patients who want to avoid surgery, the scar and the need for lifetime thyroid medication. RFA is a new procedure that clinical and interventional thyroidologists need to learn. RFA out-competes surgery and...More info
Hydrodissection for Micropapillary Thyroid Cancer: When to use it.
DR.Guttler in his officeMore info
Why Thyroid RFA Should be done with the patient awake.
Use of a local to the thyroid capsule is all that is needed to control pain. The capsule has sensory nerve endings.The interior of the thyroid and nodules have no sensory nerves. The patient when awake can tell the operator if they have pain, and...More info
Thyroid RFA Danger Zones: Not just the “danger triangle”The whole Posterior half of the thyroid gland is a danger area.
Where are the critical Structures? 1.A medial located vagus nerve can be up against the nodule. It is usually located lateral to the carotid in 75%. The middle cervical sympathetic ganglion also can be near the nodule. Recurrent laryngeal nerve...More info
Alternative Therapy For Recurrent Thyroid Cancer:Ethical Issues of Patient’s Rights to Decide Therapy.
Dr.Guttler’s Case was presented at the World Congress of Thyroid Cancer WCTC 4 on 10-17-21. Case Summary One year ago patient was diagnosed with hyperparathyroidism. She elected to have a right parathyroidectomy. During the surgery the...More info
RFA for Other Head and Neck Soft tissue Benign Neoplasms
Dr Baek is to my left.More info
RFA Therapy for Small Papillary Thyroid Cancers: Alternative to Observation or Surgery.
Dr.Guttler’s comments: Read the article and see why RFA is a good alternative to active surveillance or surgery. Call me for details at 310-393-8860 or secure email at firstname.lastname@example.org Ask for Alicia Dr.G. RFA example for PTMC.A...More info
The Dangers of Thyroid RFA Under General Anesthesia.
Dr.Guttler’s comments: To avoid this kind of complication, the procedure should be performed under local anesthesia, Isthmus nodules need special preparation. In several thousand reported cases this outcome was not mentioned. It is a very...More info
RFA for Parathyroid Adenoma: Alternative to Surgery?
Dr.Guttler’s comments. The procedure used in this case report.The parathyroid adenoma was again visualized in real time using ultrasound. 2% lidocaine was used. This was followed by hydrodissection to avoid damage to the recurrent nerve. A...More info
Parathyroid Adenoma No Surgery: Radiofrequency Ablation in My Endocrine Office.
DR.Guttler’s comments: A study with 10 patients with hypercalcemia due to adenoma treated with RFA and followed for 6 months.. 7/10 had normal PTH and Calcium for 6 months. 1/10 died of pancreatitis. 2/10 lost to F/U before the 6 th month...More info