Tracheal necrosis following thyroid radiofrequency ablation

Area of Science:

• Endocrinology
• Minimally Invasive Surgery

Background:

• Radiofrequency ablation (RFA) is a common treatment for benign thyroid nodules.
• While generally safe, RFA carries a risk of rare but severe complications, such as tracheal necrosis.

Observation:

• A 60-year-old female experienced severe tracheal necrosis after RFA for a benign isthmic thyroid nodule under general anesthesia.
• The complication manifested as dysphonia, cervical pain, and a third-degree skin burn.

Findings:

• Key risk factors identified in this case include general anesthesia, isthmic nodule location, and large nodule volume.
• The use of a cooled electrode and "moving shot" technique did not prevent the adverse outcome.

Implications:

• Future RFA procedures for benign thyroid nodules should prioritize local anesthesia and hydrodissection to protect the trachea.
• Informed consent must thoroughly discuss potential major complications, especially for cosmetic indications.