MWA Thyroid Animation

Introducing a fairly new treatment for thyroid nodules – Microwave Ablation (MWA)
微波消融
Some explanation on the usages, advantages and disadvantages of MWA of the thyroid nodule procedures.

The thyroid gland is an important organ over the neck that produces hormones that control many bodily functions
However, the thyroid gland commonly has nodules within that can enlarge. The nodules maybe solid or cystic (fluid-filled) or a mixture of both. They are commonly non-cancerous though they can be cancerous on rare occasions.

Problems with the nodules:
1. Enlarge and may be obvious on appearance, causing cosmetic concern
2. Compress on surrounding structures causing difficulty with breathing and/or swallowing
3. Produce excessive hormone causing thyroid hormonal imbalance (commonly hyperthyroidism, rarely hypothyroidism)
MWA is a minimally-invasive approach (through 1mm incision over the skin), using low-temperature energy delivered via a wand/probe directed under ‘live’ ultrasound-guidance to the thyroid nodule, causing cell death and shrinkage.

Nodule must be confirmed via ultrasound-guided FNAC/biopsy to be definitely/unequivocally non-cancerous first (at least once or even twice in some doubtful cases).

Main usages are for large visible benign (may or may not cause compressive symptoms) or hyperfunctioning nodules causing hyperthyroidism.

Usage in thyroid cancer or metastatic lymph node cases not recommended as first-line treatment but subject to case-to-case review and discussion.

Advantage of thyroid nodule MWA :
• Can be done under local anesthesia, reducing risk of general anesthesia (maybe a safer option especially for patients with multiple medical illness who cannot tolerate surgery like diabetes, severe heart failure)
• Usually done as a daycare (6-hours admission) procedure
• Much lesser side effects like vocal cord nerve injury, and no risk of hypocalcemia as compared to resection surgery
• Can be repeated few months later for additional shrinkage effect.
• Can effectively shrink down the nodule to a smaller less obvious size
• Does not take away the opportunity for future resection surgery (if patient eventually requires/requests for total nodule resection)
• Coverage available for medical insurance policyholders
• May be cheaper than the resection surgery

Disadvantage of thyroid nodule MWA :
• All thyroid surgeries come with risk of bleeding, vocal cord nerve injury, neighbouring structures injury though MWA comes with much less of that
• The nodule remains hence MWA is not an actual removal of the nodule but rather to shrink down a large visible nodule or to reduce its hyperfunctioning. Hence large thyroid or those with compressive effects already may not be suitable candidates.

MWA bears many similarities with the RFA (radiofrequency ablation) technology except for minor technical details
As we handle many different treatment methods for different thyroid diseases, we shall be able to also suggest alternative treatment options for you, from conservative, watch-and-wait option, shrinkage to total removal/resection of the lesions. We will assess each patient on a unique case-to-case basis for diagnosis and treatment, hoping for the best outcome in each case. COMMITTED TO YOUR WELL-BEING.

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The Vincent Ear, Nose, Throat (ENT), Thyroid, Head & Neck Biopsy & Surgery Specialist Clinic is based in KPJ Klang, Selangor
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