SCLEROTHERAPY

US examination for initial assessment and confirmation.
Biopsy: Two separate US-guided FNA biopsies for cytological confirmation of benignity
Volume Calculation
Symptom Assessment, including cosmetic aspect
Nodule Characteristics

Time-out
Wash with chlorhexidine
Sterile draping
Local anesthesia with 2% lidocaine, only as indicated
Perform ultrasound description and volume measurement of the thyroid cyst
Connect the needle to a three-way stopcock, with one port for aspiration (syringe) and the other for saline solution (syringe)
Puncture the thyroid cyst and completely aspirate its contents
Irrigate the cyst cavity with isotonic saline solution at least twice, until retrieved fluid is clear or sanguineous and the cyst is drained
Rinse the cyst cavity with a comparable volume of 96% ethanol, repeat washing (at least twice or more if needed) until the aspirated fluid is clear
Re-instill the cyst cavity with a comparable amount of ethanol and maintain exposure for at least 5 minutes
Completely remove the ethanol
Apply pressure to the puncture site until bleeding stops
Sign-out