Risk factors for recurrent laryngeal nerve injury in microwave ablation of thyroid nodules: A multicenter study

•Clinicians should pay attention to several influencing factors for RLN injury.•Safe TEG-D thresholds were 2.2 mm for benign nodules and 4.9 mm for malignant ones.•TEG-D was an independent risk factor for recovery time of hoarseness. This study aimed to investigate the risk factors for recurrent lar...

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Published in:Radiotherapy and oncology 2024-11, Vol.200, p.110516, Article 110516
Main Authors: Xu, Ming-hong, Dou, Jian-ping, Guo, Mo-han, Yi, Wen-qi, Han, Zhi-yu, Liu, Fang-yi, Yu, Jie, Cheng, Zhi-gang, Yu, Xiao-ling, Wang, Hui, Bai, Nan, Wang, Shu-rong, Yu, Ming-an, Liang, Ping, Chen, Lei
Format: Article
Language:English
Subjects:
Ablation Techniques - adverse effects
Ablation Techniques - methods
Adult
Female
Hoarseness - etiology
Humans
Male
Microwave ablation
Microwaves - adverse effects
Microwaves - therapeutic use
Middle Aged
Recurrent laryngeal nerve
Recurrent Laryngeal Nerve Injuries - etiology
Retrospective Studies
Risk factor
Risk Factors
Thyroid nodule
Thyroid Nodule - pathology
Thyroid Nodule - surgery
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Summary:•Clinicians should pay attention to several influencing factors for RLN injury.•Safe TEG-D thresholds were 2.2 mm for benign nodules and 4.9 mm for malignant ones.•TEG-D was an independent risk factor for recovery time of hoarseness. This study aimed to investigate the risk factors for recurrent laryngeal nerve (RLN) injury after microwave ablation (MWA) of thyroid nodules and to identify factors influencing the recovery time of post-procedure hoarseness. We retrospectively analyzed data from patients who underwent MWA for thyroid nodules at five hospitals between November 2018 and July 2022. Patients were divided into malignant and benign nodule groups. Variables analyzed included nodule size and location, the shortest distance from nodules to the thyroid capsule and tracheoesophageal groove (TEG-D), and ablation parameters. Univariate and multivariate analyses were performed to identify risk factors. Kaplan-Meier and Cox analyses were used to evaluate the recovery time of hoarseness after MWA. The study included 1,216 patients (mean age 44 ± 12 [SD] years; 901 women) with 602 malignant nodules and 614 benign nodules. The posterior capsule distance (PCD) and TEG-D were identified as independent influencing factors for hoarseness in all patients (P = 0.014, OR = 0.068; P 
ISSN:0167-8140
1879-0887
1879-0887
DOI:10.1016/j.radonc.2024.110516