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...
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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 infoRFA 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...
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DR.Guttler in his office
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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...
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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...
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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...
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Dr Baek is to my left.
More infoDr.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 thyroid.manager@thyroid.com Ask for Alicia Dr.G. RFA example for PTMC.A...
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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...
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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...
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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...
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