양성 갑상선 낭종에 대한 경화 치료의 유용성: 전향적 연구
The Utility of Sono-Guided Sclerotherapy for Benign Thyroid Cyst: Prospective Study
0
조회
0
다운로드
4
인용
0
참고문헌
키워드
초록
Background and Objectives Ultrasonography (USG)-guided sclerotherapy using a sclerotherapic agent such as ethanol, OK-432, recently has gained popularity as a treatment for nonfunctioning benign thyroid nodules. The study evaluates the efficacy and safety of the USG-guided sclerotherapy for that purpose. Subjects and Method Included in the study were 23 patients who had complaints of applied pressure or cosmetic problems due to cystic thyroid nodules, which had been diagnosed as benign and nonfunctioning by fine-needle aspiration biopsy and thyroid function test. Sclerotherapy was performed with OK-432 or 99.9% ethanol following nearly complete evacuation of the fluid from the cystic portion of thyroid nodule. At each USG follow-up, we measured the volume of cysts, symptom scores, cosmetic scores using a visual analog scale, and related complications were examined at postoperative dates of one and six months. Results The volume of thyroid cysts were significantly reduced (p＜0.01) with mean volume reduction rates of 77.3±21.2% at postoperative 6 months. The cosmetic score and symptom score were significantly improved following sclerotherapy (p＜0.01). Major complications related to sclerotherapy, such as vocal cord paralysis, thyrotoxicosis and tissue necrosis, did not happen during the follow-up observation. Conclusion USG-guided sclerotherapy could be a simple and effective treatment modality for benign cystic thyroid nodules. Korean J Otorhinolaryngol-Head Neck Surg 2012;55:777-81
Abstract
Background and Objectives Ultrasonography (USG)-guided sclerotherapy using a sclerotherapic agent such as ethanol, OK-432, recently has gained popularity as a treatment for nonfunctioning benign thyroid nodules. The study evaluates the efficacy and safety of the USG-guided sclerotherapy for that purpose. Subjects and Method Included in the study were 23 patients who had complaints of applied pressure or cosmetic problems due to cystic thyroid nodules, which had been diagnosed as benign and nonfunctioning by fine-needle aspiration biopsy and thyroid function test. Sclerotherapy was performed with OK-432 or 99.9% ethanol following nearly complete evacuation of the fluid from the cystic portion of thyroid nodule. At each USG follow-up, we measured the volume of cysts, symptom scores, cosmetic scores using a visual analog scale, and related complications were examined at postoperative dates of one and six months. Results The volume of thyroid cysts were significantly reduced (p＜0.01) with mean volume reduction rates of 77.3±21.2% at postoperative 6 months. The cosmetic score and symptom score were significantly improved following sclerotherapy (p＜0.01). Major complications related to sclerotherapy, such as vocal cord paralysis, thyrotoxicosis and tissue necrosis, did not happen during the follow-up observation. Conclusion USG-guided sclerotherapy could be a simple and effective treatment modality for benign cystic thyroid nodules. Korean J Otorhinolaryngol-Head Neck Surg 2012;55:777-81
참고문헌 (18)
- Mortensen JD, "Gross and microscopic findings in clinically normal thyroid glands", J Clin Endocrinol Metab, 15(10), pp.1270~1280 (1955)
- Bennedbaek FN, "Management of the solitary thyroid nodule: results of a North American survey", J Clin Endocrinol Metab, 85(7), pp.2493~2498 (2000)
- Edmonds CJ, "Treatment of thyroid cysts by aspiration and injection of sclerosant", Br Med J (Clin Res Ed), 295(6597), pp.529~ (1987)
- McCowen KD, "The role of thyroid therapy in patients with thyroid cysts", Am J Med, 68(6), pp.853~855 (1980)
- Miller JM, "The cystic thyroid nodule. Recognition and management", Radiology, 110(2), pp.257~261 (1974)
- Sung JY, "Optimum first-line treatment technique for benign cystic thyroid nodules: ethanol ablation or radiofrequency ablation?", AJR Am J Roentgenol, 196(2), pp.W210~W214 (2011)
- Cho YS, "Sonographically guided ethanol sclerotherapy for benign thyroid cysts: results in 22 patients", AJR Am J Roentgenol, 174(1), pp.213~216 (2000)
- Yasuda K, "Treatment of cystic lesions of the thyroid by ethanol instillation", World J Surg, 16(5), pp.958~961 (1992)
- Hegedü L, "Tetracycline for sclerosis of thyroid cysts. A randomized study", Arch Intern Med, 148(5), pp.1116~1118 (1988)
- McClatchey KD, "Plunging ranula", Oral Surg Oral Med Oral Pathol, 57(4), pp.408~412 (1984)
- Fukase S, "Treatment of ranula wth intracystic injection of the streptococcal preparation OK-432", Ann Otol Rhinol Laryngol, 112(3), pp.214~220 (2003)
- Livraghi T, "Treatment of autonomous thyroid nodules with percutaneous ethanol injection: preliminary results. Work in progress", Radiology, 175(3), pp.827~829 (1990)
- Kim MJ, "US-guided Fine-Needle Aspiration of Thyroid Nodules: Indications, Techniques, Results", Radiographics, 28(7), pp.1869~1886
- Verde G, "Ultrasound guided percutaneous ethanol injection in the treatment of cystic thyroid nodules", Clin Endocrinol (Oxf), 41(6), pp.719~724 (1994)
- Zingrillo M, "Percutaneous ethanol injection may be a definitive treatment for symptomatic thyroid cystic nodules not treatable by surgery: five-year follow-up study", Thyroid, 9(8), pp.763~767 (1999)
- Bennedbaek FN, "Treatment of recurrent thyroid cysts with ethanol: a randomized double-blind controlled trial", J Clin Endocrinol Metab, 88(12), pp.5773~5777 (2003)
- Monzani F, "Percutaneous aspiration and ethanol sclerotherapy for thyroid cysts", J Clin Endocrinol Metab, 78(3), pp.800~802 (1994)
- Kobayashi A, "Thyrotoxicosis after needle aspiration of thyroid cyst", J Clin Endocrinol Metab, 75(1), pp.21~24 (1992)