UAE: Doctors perform rare, minimally invasive treatment of thyroid nodules

Doctors at Abu Dhabi’s Sheikh Khalifa Medical City (SKMC) successfully conducted laser ablation of benign and non-cancerous thyroid nodules in a 48-year-old woman.

The minimally invasive procedure has helped Rula Shukair avoid surgery for the removal of her thyroid gland and spared her from a lifelong dependence on medication to maintain normal metabolism. She also became the first patient at the hospital to undergo this innovative procedure.

A thyroid nodule is a palpable swelling in the thyroid gland with an otherwise normal appearance. They are common and may be caused by a variety of thyroid disorders. While most are benign, about 5 per cent of all palpable nodules are cancerous. Benign nodules can cause symptoms such as difficulty in swallowing, breathing, neck discomfort or choking.

Rula had three nodules at the right of her thyroid gland and three at the left. She had been following up at the ENT department every six months for observation, ultrasound, and other tests to monitor the size of the nodules.

In her last follow-up, doctors noticed an enlargement of one of the nodules, and the ENT surgeon suggested laser ablation, which is a procedure to reduce the size of benign thyroid nodules that are symptomatic. Non-cancerous nodules require removal upon enlargement as they may obstruct swallowing and breathing.

“This technique is performed while the patient is conscious, under local anaesthesia. A thin needle, less than 1 millimeter in diameter, is inserted into the target thyroid nodule under ultrasound guidance. Laser treatments are performed through the needle, and the amount of energy delivered is planned and pre-calculated based on the size of the nodule,” said Dr Shaik Irfan Basha, consultant otorhinolaryngology and head and neck surgery, and the Chair of the Department of Surgery, SKMC, part of the Abu Dhabi Health Services Company (Seha).

“Patients recover within two hours and are discharged on the same day without the need for any further medication. They can resume work and other activities the very next day and are evaluated immediately after the procedure, one month after, and again at 12 months.”

Dr Basha noted that laser ablation therapy for benign thyroid nodules is a new, non-surgical procedure that is effective and has a very low risk of major complications.

“Our thyroid is a vital organ that regulates metabolism, growth, and development. Laser ablation allows us to preserve the organ.”

The ideal candidates for this procedure are thyroid patients who have benign thyroid nodules, multinodular compressive goitre (enlarged thyroid) producing a bulge in the neck and aesthetic discomfort, compressive symptoms such as difficulty in swallowing and breathing, or large mass that displaces the trachea.

Additionally, the procedure can also be ideal for certain patients who refuse to undergo partial or complete surgical removal of the thyroid gland out of concern of long-life consumption of levothyroxine that cannot completely replace the function of the thyroid gland.

“I was thrilled when Dr Basha informed me that I will be the first candidate at SKMC to undergo laser ablation of the nodules,” Rula said.

“I was relieved that I wouldn’t have to undergo surgery or have my thyroid gland removed. Now, I do not need any medication, nor do I have any scars on my neck. I am truly grateful to the doctors and the entire team at SKMC,” she added.

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