Non-surgical Goiter Treatment

If biopsies of patients with nodular goiter reveal benign nodules, follow-up or percutaneous ablation may be performed. Traditionally, if the nodule is small, not growing, and the patient has no symptoms, follow-up is sufficient. However, if the nodule grows or causes symptoms, surgical treatment is recommended.

Thyroid surgery leaves a permanent incision in the neck, the patient often has to take synthetic hormones for life after the surgery, and the risks associated with anesthesia make many people reluctant to undergo surgery. Consequently, some patients' nodules can grow to very large sizes without treatment. For goiter patients with benign nodules who do not wish to undergo surgery, percutaneous ablation treatments offer a valuable alternative.

While the word "percutaneous" means inserting a needle through the skin, "ablation" means vaporizing the nodule using heat. With this method, no incision is made; treatment is performed through a single needle puncture. Percutaneous ablation methods are a very good alternative to surgery, and experienced interventional radiologists in our country successfully perform non-surgical thyroid nodule treatments (percutaneous ablation).

Percutaneous ablation is very similar to a thyroid biopsy. In a biopsy, we insert a needle into the nodule, extract cells, and remove them. However, in ablation therapy, we use a special needle. After local anesthesia, we apply heat to the thyroid nodule, vaporizing it. This treatment, which is quite safe in experienced hands, allows patients to return to their normal lives immediately and walk out of the hospital.

Embolization is a rarely used nonsurgical treatment for MNG. "Embolization" means blocking a blood vessel in the body. This treatment involves closing three of the four blood vessels that cause the thyroid to enlarge, thus reducing its size. In embolization, an angiogram is inserted through the groin and the arteries feeding the thyroid gland are blocked with tiny particles. The thyroid gland shrinks but retains its vitality. The procedure is performed in the groin under local anesthesia, just like a cardiac angiogram.

Embolization has advantages over surgery in MNG patients.

• Unlike surgery and radioactive iodine therapy, hypothyroidism does not develop, so the patient does not have to take synthetic hormone medication for life.
• Surgery-related complications such as neck scarring, hoarseness, and hypoparathyroidism (which occurs when the parathyroid glands adjacent to the thyroid are accidentally removed) are avoided.