Nerve Injury During Thyroid Radiofrequency Ablation: Mechanisms, Prevention, and Practical Management.
- 1Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea.
- 2Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea. [email protected].
Abstract
Voice change is an uncommon but clinically important complication of thyroid radiofrequency ablation (RFA), because it may indicate injury to the recurrent laryngeal nerve or, less commonly, the vagus nerve. Early recognition and appropriate intervention are important, because neural dysfunction may remain reversible before the occurrence of irreversible structural nerve injury. Thermal nerve injury during thyroid RFA is not always a single instantaneous event. Rather, it may involve direct thermal exposure of the nerves, leading to acute endoneurial or perineural edema, microvascular compromise, and delayed inflammation or fibrosis. Therefore, a practical approach to the management of voice changes during thyroid RFA should emphasize prevention, frequent intraprocedural voice assessment, immediate cessation of ablation, and prompt bolus injection of cold 5% dextrose in water. After adequate cooling, local dexamethasone injections and a short course of oral corticosteroid therapy may be considered. In conclusion, a mechanism-based framework may improve operator preparedness and reduce the risk of persistent nerve dysfunction.
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BibTeX
@article{lim2026nerve,
title = {{Nerve Injury During Thyroid Radiofrequency Ablation: Mechanisms, Prevention, and Practical Management.}},
author = {Hunjong Lim and Jung Hwan Baek},
journal = {Korean journal of radiology},
year = {2026},
month = oct,
doi = {10.3348/kjr.2026.0878},
url = {https://europepmc.org/article/MED/42849889},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Nerve Injury During Thyroid Radiofrequency Ablation: Mechanisms, Prevention, and Practical Management.
AU - Hunjong Lim
AU - Jung Hwan Baek
PY - 2026
DA - 2026/10/01
JO - Korean journal of radiology
DO - 10.3348/kjr.2026.0878
UR - https://europepmc.org/article/MED/42849889
AB - Voice change is an uncommon but clinically important complication of thyroid radiofrequency ablation (RFA), because it may indicate injury to the recurrent laryngeal nerve or, less commonly, the vagus nerve. Early recognition and appropriate intervention are important, because neural dysfunction may remain reversible before the occurrence of irreversible structural nerve injury. Thermal nerve injury during thyroid RFA is not always a single instantaneous event. Rather, it may involve direct thermal exposure of the nerves, leading to acute endoneurial or perineural edema, microvascular compromise, and delayed inflammation or fibrosis. Therefore, a practical approach to the management of voice changes during thyroid RFA should emphasize prevention, frequent intraprocedural voice assessment, immediate cessation of ablation, and prompt bolus injection of cold 5% dextrose in water. After adequate cooling, local dexamethasone injections and a short course of oral corticosteroid therapy may be considered. In conclusion, a mechanism-based framework may improve operator preparedness and reduce the risk of persistent nerve dysfunction.
SN - 1229-6929
SN - 2005-8330
ER -