Alcohol Sclerotherapy of Benign Thyroid Nodule

Usually malignant thyroid nodules require surgical removal. Benign thyroid cystic nodules associated with symptoms and/or cosmetic problems may be considered for treatment. One of the minimally invasive treatments is alcohol ablation of the benign thyroid cyst, known as sclerotherapy. This procedure is done under ultrasound guidance and involves using a needle(s) to remove as much of the cyst fluid as possible and injecting 99% ethanol into the cyst cavity via the same needle(s). The alcohol is left in place for a few minutes, and subsequently completely aspirated. Alcohol causes shrinkage of the thyroid cyst due protein denaturation and inflammatory fibrosis after contacting the cyst wall. 

Randomised trials of alcohol sclerotherapy have shown a greater reduction in cyst volume and lower recurrence rate compared to pure aspiration alone.

Pain during and immediately after the procedure is the major side effect of alcohol ablation. Studies have shown that up to 20 percent of patients had transient moderate to severe pain. However, this procedure is well tolerated, and is usually performed under local anesthesia. This has the additional advantage of allowing monitoring for potential nerve injury which can cause hoarseness. At the end of the procedure, the needle will be removed and the insertion site will be dressed.  You should be able to go home after 4 hours of monitoring at the Interventional Radiology Centre recovery area. 

Other available options for management of benign symptomatic thyroid nodules include radiofrequency ablation, percutaneous laser ablation (PLA), high-intensity focused ultrasound (HIFU) as well as surgery. Your doctor will discuss with you the best course of treatment in your case.