Radiofrequency ablation (RFA) has gained recognition as a highly effective and safe minimally invasive alternative treatment for well-selected patients with benign thyroid nodules and recurrent thyroid cancer. Despite the well-known efficacy of RFA, head and neck surgeons have had minimal involvement in both establishing clinical evidence and developing most RFA guidelines. This is partly due to the challenges surgeons face in understanding and applying these imaging-guided interventions. However, head and neck surgeons possess extensive knowledge of surgical anatomy and have significant clinical experience with the anatomical relationships of surrounding structures, which could enhance the safety and effectiveness of RFA. Their expertise allows for better management of rare but serious complications such as bleeding, airway compression, recurrent laryngeal nerve paralysis, and tumor rupture. Drawing from my experience as a head and neck surgeon with RFA, this article aims to elucidate the principles, indications, preparation, and procedure of RFA for benign and malignant thyroid tumors.

Radiofrequency ablation (RFA) has gained recognition as a highly effective and safe minimally invasive alternative treatment for well-selected patients with benign thyroid nodules and recurrent thyroid cancer. Despite the well-known efficacy of RFA, head and neck surgeons have had minimal involvement in both establishing clinical evidence and developing most RFA guidelines. This is partly due to the challenges surgeons face in understanding and applying these imaging-guided interventions. However, head and neck surgeons possess extensive knowledge of surgical anatomy and have significant clinical experience with the anatomical relationships of surrounding structures, which could enhance the safety and effectiveness of RFA. Their expertise allows for better management of rare but serious complications such as bleeding, airway compression, recurrent laryngeal nerve paralysis, and tumor rupture. Drawing from my experience as a head and neck surgeon with RFA, this article aims to elucidate the principles, indications, preparation, and procedure of RFA for benign and malignant thyroid tumors.

Radiofrequency ablation (RFA) has gained recognition as a highly effective and safe minimally invasive alternative treatment for well-selected patients with benign thyroid nodules and recurrent thyroid cancer. Despite the well-known efficacy of RFA, head and neck surgeons have had minimal involvement in both establishing clinical evidence and developing most RFA guidelines. This is partly due to the challenges surgeons face in understanding and applying these imaging-guided interventions. However, head and neck surgeons possess extensive knowledge of surgical anatomy and have significant clinical experience with the anatomical relationships of surrounding structures, which could enhance the safety and effectiveness of RFA. Their expertise allows for better management of rare but serious complications such as bleeding, airway compression, recurrent laryngeal nerve paralysis, and tumor rupture. Drawing from my experience as a head and neck surgeon with RFA, this article aims to elucidate the principles, indications, preparation, and procedure of RFA for benign and malignant thyroid tumors.

Radiofrequency ablation (RFA) has gained recognition as a highly effective and safe minimally invasive alternative treatment for well-selected patients with benign thyroid nodules and recurrent thyroid cancer. Despite the well-known efficacy of RFA, head and neck surgeons have had minimal involvement in both establishing clinical evidence and developing most RFA guidelines. This is partly due to the challenges surgeons face in understanding and applying these imaging-guided interventions. However, head and neck surgeons possess extensive knowledge of surgical anatomy and have significant clinical experience with the anatomical relationships of surrounding structures, which could enhance the safety and effectiveness of RFA. Their expertise allows for better management of rare but serious complications such as bleeding, airway compression, recurrent laryngeal nerve paralysis, and tumor rupture. Drawing from my experience as a head and neck surgeon with RFA, this article aims to elucidate the principles, indications, preparation, and procedure of RFA for benign and malignant thyroid tumors.

Radiofrequency ablation (RFA) has gained recognition as a highly effective and safe minimally invasive alternative treatment for well-selected patients with benign thyroid nodules and recurrent thyroid cancer. Despite the well-known efficacy of RFA, head and neck surgeons have had minimal involvement in both establishing clinical evidence and developing most RFA guidelines. This is partly due to the challenges surgeons face in understanding and applying these imaging-guided interventions. However, head and neck surgeons possess extensive knowledge of surgical anatomy and have significant clinical experience with the anatomical relationships of surrounding structures, which could enhance the safety and effectiveness of RFA. Their expertise allows for better management of rare but serious complications such as bleeding, airway compression, recurrent laryngeal nerve paralysis, and tumor rupture. Drawing from my experience as a head and neck surgeon with RFA, this article aims to elucidate the principles, indications, preparation, and procedure of RFA for benign and malignant thyroid tumors.

BACKGROUND AND OBJECTIVES: Although anaplastic thyroid carcinoma (ATC) accounts for less than 2% of all thyroid malignancies, it contributes to 14-50% of deaths related to thyroid tumors. However, there is no definite treatment. The aim of the study is to review our experience of ATC at our own university clinic to look for clues for the management of ATC. SUBJECTS AND METHOD: The medical record of 15 patients with ATC treated in our clinic between 1997 and 2010 were retrospectively reviewed. RESULTS: Five (33.3%) patients underwent no curative treatment but biopsy or tracheostomy. Complete surgical resection was possible in only one patient. Six patients underwent debulking surgery with or without adjuvant treatment. One and two patients were treated with radiation therapy alone and concurrent chemoradiation therapy (CCRT), respectively. Despite various treatment regimens, there are surviving patients at the time of present evaluation. The mean survival was 253.1 days and median survival was 128 days. Only two patients had survived longer than a year. Each patient had been treated with complete surgical resection and CCRT with doxorubicin, respectively. In univariate analysis, there was no association between survival duration and various clinico-pathological parameters. However, old age (> or =65), history of pre-existing thyroid nodule, and radiation therapy was significantly associated with survival duration in multivariate analysis. CONCLUSION: Most ATC was unresponsive to ongoing treatment modalities in our clinic. However, we experienced that a certain treatment was effective in some patients. For the goal of forming a generally effective treatment regimen for ATC, we suggest a prospective multicenter study to be performed on the basis of present study.
Biopsy ; Doxorubicin ; Humans ; Medical Records ; Retrospective Studies ; Thyroid Gland ; Thyroid Neoplasms ; Thyroid Nodule ; Tracheostomy

Here, we describe two cases of cervical bronchogenic cysts mimicking thyroid cancer on ultrasound (US), introducing some sources of diagnostic error with the aim of improving the understanding of cervical bronchogenic cysts. In these cases, US demonstrated ill-defined nonhomogeneous hypoechoic nodules at the inferior pole of the thyroid gland, exhibiting several echogenic foci that mimicked microcalcification of papillary thyroid carcinoma. Although cervical bronchogenic cysts can be presented as highly suspicious thyroid nodules on US, recognition of this disease entity and comprehensive understanding of its presentation can allow an appropriate diagnostic process without unnecessary diagnostic surgery.

In the last few decades, the standard surgical treatment for primary hyperparathyroidism (PHPT) has shifted from bilateral neck exploration to focused/minimally invasive parathyroidectomy (FMIP). This shift was accelerated by the introduction of intraoperative parathyroid hormone (IOPTH) monitoring, which can provide intraoperative information regarding the localization and complete excision of the pathological parathyroid gland during FMIP. Since the first clinical application of the IOPTH assay in 1991, IOPTH monitoring has substantially improved to date to increase its performance and availability. In addition, the clinical applications of IOPTH changed with the needs of actual clinical practice, although the fundamental concept and technique remained unchanged. In this review, we discuss the role of IOPTH monitoring in the surgical management of PHPT based on the results of contemporary studies and summarized the major issues regarding IOPTH.

OBJECTIVES: Numerous studies have reported the effects of subclinical hyperthyroidism on the cardiovascular system, osteoporosis, and metabolic syndrome. However, there are few studies examining the relationships between subclinical hyperthyroidism and thyroid cancer. The aim of this study was to investigate the relationships between preoperative subclinical hyperthyroidism and clinicopathological characteristics in patients with papillary thyroid carcinoma (PTC) in terms of thyroid-stimulating hormone (TSH) levels and TSH receptor antibody (TRAb) values. METHODS: Between January 2001 and December 2007, 462 patients were eligible for analysis in our study; we compared the clinicopathological characteristics of 39 preoperative subclinical hyperthyroidism patients with those of 423 euthyroid patients. RESULTS: There were no statistical differences between the 2 groups with respect to age, male to female ratio, primary tumor size, extrathyroidal extension (ETE), multifocality, lymph node metastasis, TNM and AMES stages, recurrence, and survival, despite significant difference in TSH concentrations between the 2 groups. In the evaluation for TRAb, primary tumor size was significantly larger in patients with normal TRAb than in patients with elevated TRAb. When the patients were subdivided into 4 categories according to TRAb values (<5.0%; 5.0%-10.0%; 10.1%-15.0%; >15.0%), tumor size and ETE were significantly different. However, we could not find linear relationships in the increase or decrease of TRAb values. CONCLUSION: The results of our study suggest that subclinical hyperthyroidism is not independently associated with tumor aggressiveness and prognosis in PTC in spite of reduced TSH levels and increased TRAb values as compared with euthyroid patients.
Carcinoma, Papillary ; Cardiovascular System ; Female ; Humans ; Hyperthyroidism* ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Osteoporosis ; Prognosis ; Receptors, Thyrotropin ; Recurrence ; Thyroid Gland ; Thyroid Neoplasms* ; Thyrotropin

OBJECTIVES: Somatostatin inhibits lymph production and reduces lymph flow into the lymphatic duct. We hypothesized that octreotide, a long-acting somatostatin analog, would reduce drainage after neck dissection (ND) by reducing the overall lymphatic flow in the neck as well as thoracic duct flow. METHODS: From 2012 to 2014, total 123 patients who had undergone left-sided comprehensive ND, were divided into an octreotide group (49 patients) and a control group (74 patients). Seventeen patients from the octreotide group and 17 from the control group were individually matched by age (±10 years), sex, body mass index (±1 kg/m2), type of cancer, surgeon, and the extent of surgery. These 34 patients were finally included in the study. RESULTS: The total fluid drainage volume (540.9 mL vs. 707.9 mL) and drainage volume during the period of octreotide use (the first 5 postoperative days) (461.1 mL vs. 676.4 mL) were significantly lower in the octreotide group. The duration of drain placement (6.3 days vs. 9.4 days) was also shorter in the octreotide group. In the octreotide group, the mean triglyceride concentration in the drainage fluid was significantly lower than that in the control group (43.1 mg/dL vs. 88.8 mg/dL). There was no complication associated with the use of octreotide. CONCLUSION: Our study has shown that postoperative octreotide injections reduce postoperative drainage and the duration of drain placement. Further studies with larger patient populations are warranted to confirm these results and to evaluate the clinical benefits for patients.
Body Mass Index ; Case-Control Studies* ; Chyle ; Drainage* ; Humans ; Neck Dissection* ; Neck* ; Octreotide* ; Prospective Studies* ; Somatostatin ; Thoracic Duct ; Triglycerides