Thyroid Radiofrequency Ablation-Thermal Effects on Recurrent Laryngeal Nerve Using Continuous Intraoperative...

Area of Science:

• Endocrinology
• Surgical Innovation
• Medical Device Technology

Background:

• Recurrent laryngeal nerve (RLN) injury is a risk during radiofrequency ablation (RFA) for thyroid nodules.
• Intraoperative neuromonitoring (IONM) is crucial for preventing RLN damage.
• Establishing thermal safety parameters for RFA is essential for safe thyroid treatments.

Purpose of the Study:

• To investigate the thermal safety parameters of thyroid RFA using IONM in a porcine model.
• To determine the safe distances between the RFA active tip and the RLN at various power settings.
• To assess the effectiveness of cooling methods and residual heat effects on the RLN.

Main Methods:

• A porcine animal model was used in a university laboratory setting.
• Twelve piglets underwent RFA with continuous IONM, recording electromyography (EMG) signal changes.
• Spread heat and residual heat studies were conducted to evaluate thermal injury thresholds and cooling durations.

Main Results:

• Signal attenuation occurred at distances of 2-5 mm depending on RFA power (10-50W).
• No signal recovery was observed in injured RLN areas, even with irrigation.
• Minimal residual heat effects were noted, with no significant signal attenuation in residual heat experiments.

Conclusions:

• This study established thermal safety parameters for thyroid RFA in a porcine model.
• Findings can help operators define precise ablation fields and ensure safe RFA treatment.
• The research provides critical data for optimizing RFA procedures to prevent RLN injury.