- Pain or discomfort in the neck for two or three days, sometimes radiating to the jaw or ear, is expected and is managed with common painkillers.
- Complications are uncommon: a little over two in a hundred overall, and serious ones a little over one in a hundred.
- Fever, swelling that grows, difficulty breathing or a voice change that does not improve are reasons to call the same day.
The procedure is performed under local anesthesia, with the electrode visible on screen at all times. After a short period of observation, you go home the same day, with no need for admission. What follows describes the days after, as the guidelines and published series record them, and what you are told at the consultation about returning to your routine.
What is expected
- 01That dayYou leave with no stitches and no dressing. Your neck may feel warm or tight, with some discomfort when swallowing.
- 02Two or three daysThat is how long pain usually lasts, according to the guidelines, with common painkillers. It can radiate to the jaw, ear, shoulder or even the teeth: it is the same nerve, not a complication.
- 0324 to 48 hoursThat is how long most people take to return to their routine, per Dr. Jacobo's indication. Some bruising may remain for a few days.
- 04Weeks and monthsThe nodule does not disappear immediately: the body reabsorbs it gradually. Symptom relief comes before the final ultrasound figure.
If you have blood tests in the first week
They may come back abnormal in the opposite direction to the one feared: a temporary excess of hormone, because the heated nodule releases what it had stored. It happens in more than a third of patients, almost always without symptoms, and settles on its own. That is why thyroid function is checked at the first-year follow-ups, not three days later.
Complications, with numbers
No procedure carries zero risk, and what can be done is to measure it. The reference meta-analysis, with more than two thousand patients, gives an overall rate of a little over two in a hundred and a major-complication rate of a little over one in a hundred, with none potentially life-threatening reported.
- 2.38 %complications in total, y major ones, 1.35 %. None potentially life-threatening.Chung SR, Suh CH, Baek JH et al. Int J Hyperthermia. 2017, 33(8): 920-930. 24 studies, 2,421 patients.
- 1.02 %voice change. Nerve paresis is usually transient and resolves in two to three months, and permanent injury is described in 0 to 0.17 %.Issa PP et al. Gland Surg. 2024, 13(1): 77-86.
- Hematoma: 0.9 to 2.1 %. A small bruise is normal, and swelling that grows is worth having checked.
- Nodule rupture: 0.19 to 2.5 %. It shows as swelling and pain weeks later, and it is treated.
- Skin burn: 0.27 %.
- Infection or fever: 0.3 to 6 %.
A more recent series, of 620 nodules at three North American centers, gives an overall rate of 3.2 % and no permanent voice change. The numbers vary little between series, and what keeps them low is working with the electrode on screen, entering through the center of the neck and keeping the voice nerve located at all times.
When to call the same day
- Kim JH et al. 2017 Thyroid Radiofrequency Ablation Guideline: Korean Society of Thyroid Radiology. Korean J Radiol. 2018, 19(4): 632-655.
- Chung SR, Suh CH, Baek JH et al. Int J Hyperthermia. 2017, 33(8): 920-930.
- Issa PP et al. Gland Surg. 2024, 13(1): 77-86.
- Russell JO et al. Surgery. 2024, 175(1): 139-145.
- Wang N et al. Int J Hyperthermia. 2021, 38(1): 1060-1068.
