Direct Ice Packing for Voice Changes During Thyroid Radiofrequency Ablation: A Retrospective Case Series.

Area of Science:

• Otolaryngology
• Interventional Radiology
• Ultrasound Technology

Background:

• Voice change is a known complication of radiofrequency ablation (RFA) for thyroid nodules, often due to thermal injury to the recurrent laryngeal nerve.
• While spontaneous recovery is common, prompt interventions can alleviate patient distress and anxiety associated with voice alterations.

Purpose of the Study:

• To evaluate the efficacy and safety of direct ice packing as a management strategy for voice changes occurring during or immediately after RFA for benign thyroid nodules.

Main Methods:

• A retrospective case series involving five patients who experienced voice changes post-RFA.
• Ipsilateral vocal cord (VC) hypomobility was diagnosed using real-time laryngeal ultrasound.
• Ice was applied directly to the skin overlying the thyroid, with VC movement and skin integrity monitored every 10 minutes.

Main Results:

• All five patients experienced complete resolution of voice change symptoms within 20-50 minutes (median 30 minutes).
• The intervention was well-tolerated, with no reported complications such as cold-induced skin injury.
• No additional treatments were required for symptom management.

Conclusions:

• Direct ice packing appears to be a safe, practical, and noninvasive option for managing acute voice changes after RFA of thyroid nodules.
• The rapid symptom improvement suggests potential efficacy, though further research in larger populations is needed to confirm these findings.