Abstract:

Since 2000, ultrasonography-guided thermal ablation has been widely applied in treating benign thyroid nodule(BTN). However, considering complicated structures of thyroid gland and its surrounding tissues，various complications （such as voice change and hematoma）have been reported and attracted clinical attention. Intraoperative complications encountered in thermal ablation of BTN comprises of nerve (including the recurrent laryngeal nerve, sympathetic nerve and brachial plexus nerve) injury, vascular injury, skin burn and surrounding tissue burn, while postoperative complications mainly include nodule rupture, liquefactive necrosis and abnormal thyroid function. Among intraoperative complications, nerve injury is characterized by vocal changes, which is the most common complication. In the treatment of BTN using radiofrequency ablation and microwave ablation, occurrence rate of vocal changes is 0.4% to 8.1%. Other nerve complications include Horner's syndrome and brachial plexus injury. Vascular injury manifests as bleeding and hematoma; Burns to surrounding tissues include skin burns, tracheal burns, and esophageal burns. Postoperative complications include nodule rupture and abnormal thyroid function.Nodule rupture often occurs 1 week to 6 months after surgery. Liquefactive necrosis is a rare change after BTN using thermal ablation surgery. Abnormal thyroid function includes hypothyroidism and hyperthyroidism. This article reviews the manifestations of complications during and after ultrasound-guided thermal ablation of BTN, providing reference for diagnosis and treatment of complications.

Key words: Complication, Thermal ablation, Thyroid nodule, Ultrasound