Ethanol ablation as a treatment strategy for benign cystic thyroid nodules: a comparison of the ethanol retention and aspiration techniques

PURPOSE: We compared the efficacy and safety of two ethanol ablation techniques-ethanol aspiration and ethanol retention-for benign cystic thyroid nodules. METHODS: From October 2008 to September 2013, 113 patients who were treated using the ethanol aspiration technique (February 2008 to December 2010) and 108 patients who were treated using the ethanol retention technique (January 2011 to September 2013) were enrolled (male:female ratio, 53:168; mean age, 48.1 years; range, 18 to 80 years). The patient sample had 94 cystic and 127 predominantly cystic thyroid nodules. The volume reduction ratio (VRR) at the last follow-up, improvements in symptoms and cosmetic scores, vascularity, pain, and major complications were evaluated and compared between the ethanol aspiration group and ethanol retention group. We also performed a subgroup analysis according to the proportion of the solid component, in which VRR, symptom and cosmetic scores, and therapeutic success were compared. RESULTS: No statistically significant difference in VRR was found between the ethanol retention group and the ethanol aspiration group (83.2%±32.8% vs. 86.1%±18.4%, P=0.416) while patients who underwent the retention technique were more likely to experience pain after treatment (P=0.001). VRR, symptom and cosmetic scores, and therapeutic success did not significantly differ between techniques in either group in the subgroup analysis. CONCLUSION: The ethanol aspiration technique may be preferable to the ethanol retention technique for treating benign cystic and predominantly cystic thyroid nodules, because a comparable VRR can be expected with less pain.