20 years of image guided interventional methods have emerged as alternatives for treatment. Ethanol ablation PEI has been accepted as best treatment for thyroid cysts. Thermal ablation has been successful in size reduction of thyroid nodules that...More info
Toxic Nodule Can Be Treated without RadioIodine or Surgery by Radiofrequency Ablation No Scar No Thyroid Hormone or Continued Antithyroid Drugs.
RFA can result in no more use for antithyroid drugs, no scar and no need for thyroid hormone after surgery or RAI/131 therapy. The patient as a 1 cm toxic nodule with elevated T4 and non-detectable TSH on Tapazole to control the hyperthyroidism...More info
Candidate Screening for Thyroid RFA
In all the procedures I have done with RFA for nodules and cancer I was tricked into doing the procedure on 2 patients who failed to disclose they had a problem that would have resulted in problems if not known before hand. Patient failed to list...More info
Radiofrequency Ablation as Good as Thyroid Lobectomy for Low-Risk Papillary!
Dr.Guttler’s comments: This retrospective study evaluated 884 patients with unifocal low-risk PTMC treated with TL or RFA from June 2014 to March 2018. 460 patients underwent TL (TL group) and 424 patients, who refused surgery or Active...More info
Southern California Thyroid Patients If You Have known thyroid nodules and are one of the first ten patients to call you can have a free neck ultrasound by done personally by Dr.Guttler ( $450 ) value. www.ThyroidNoSurgery.com 310-393-8860 Santa...More info
Local Toxicity From Lidocaine During Thyroid RFA
Dr.Guttler’s comments There is a limit to the amount used for skin and thyroid capsule injections. Toxic reactions are very rare. Aware of its symptoms and intravenous use of lipid emulsion are essential to preventing mortality. To relieve...More info
Ethanol PEI/Thyroid RFA treatment of Cysts Depends on the Amount of the Solid component
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