Diving thyroid nodules are a limitation of radiofrequency ablation because the mediastinal component cannot be adequately identified by ultrasound (US).We aim to describe a new technique, the iceberg technique, to overcome this issue and explain our three-year experience of using this novel method.The iceberg technique consists of a two-stage treatment.
First, the ablation of the cervical portion of the nodules (easily visualized during the initial US exam) using trans-isthmic access is att nighthawk hotspot performed using the moving-shot technique.After three to six months, there is a volumetric reduction of the treated portion, leading to retraction of the thyroid parenchyma.This brings the mediastinal component to the cervical region, thereby enabling a perfect visualization by US.
Then, the second stage of treatment is carried out with complete nodule ablation, and the region that was treated first is looked at a second time.From April 2018 to April 2021, nine patients with nine benign nodules were read more submitted for the iceberg technique.No complications occurred during the entire follow-up period.
The patients displayed normal hormonal levels after the procedures, and there was a significant volume reduction of the nodules until three months post-ablation.The iceberg technique is an effective and safe option for the radiofrequency treatment of diving goiters.