• Home
  • Practice Focus
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
    • How I Do It
    • TRIO Best Practices
  • Business of Medicine
    • Health Policy
    • Legal Matters
    • Practice Management
    • Tech Talk
    • AI
  • Literature Reviews
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Career
    • Medical Education
    • Professional Development
    • Resident Focus
  • ENT Perspectives
    • ENT Expressions
    • Everyday Ethics
    • From TRIO
    • The Great Debate
    • Letter From the Editor
    • Rx: Wellness
    • The Voice
    • Viewpoint
  • TRIO Resources
    • Triological Society
    • The Laryngoscope
    • Laryngoscope Investigative Otolaryngology
    • TRIO Combined Sections Meetings
    • COSM
    • Related Otolaryngology Events
  • Search

Office-Based FNA Thyroid Nodule Biopsies a Viable Option

by Heather Lindsey • February 1, 2008

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
Print-Friendly Version

Physicians can successfully perform ultrasound-guided (US) fine-needle aspiration biopsy (FNAB) of thyroid nodules in the office instead of referring patients to a hospital-based radiologist for the procedure, according to new data presented at the annual meeting of the American Academy of Otolaryngology-Head and Neck Surgery. It’s not all about the palate, according to Michael Freidman, MD, Professor of Otolaryngology at Rush University Medical Center in Chicago, who is known for developing the Friedman Tongue Position classification system.

You Might Also Like

  • In-Office Laryngeal Procedures in Awake Patients a Viable, and Often Preferable, Option
  • Which Ultrasound Classification System Is Best at Reducing Unnecessary Thyroid Nodule Biopsies?
  • Avoiding the Operating Room: The Advantages of Office-Based Laryngology and Esophagology
  • Many Laryngeal Biopsies Can Be Performed In-Office
Explore This Issue
February 2008

We were able to get adequate biopsy results 93% of the time without the patient having to go to a hospital-based institution, said the study’s lead author, David L. Steward, MD, Director of the Thyroid and Parathyroid Program and Associate Professor in the Department of Otolaryngology/Head and Neck Surgery at the University of Cincinnati.

Having an otolaryngologist-head and neck surgeon perform FNAB in the office saves the patient time, explained Dr. Steward. Traditionally, office-based physicians refer patients to a hospital to see a radiologist for FNAB. Another advantage of performing office-based ultrasound (US) and ultrasound-guided fine-needle aspiration (US-FNAB) is that the performing physician is familiar with the patient’s history and symptoms, he said.

Head and neck surgeons are increasingly acquiring US as part of comprehensive diagnosis and management of their patients, noted David J. Terris, MD, Porubsky Professor and Surgical Director of the Medical College of Georgia Thyroid Center in Augusta. A natural extension of this is to use the technology to perform fine-needle aspiration biopsies, he said.

The Data

Dr. Steward and his colleagues evaluated data from a prospective cohort study of 447 consecutive office-based US-FNAB procedures conducted in his practice between 2003 and 2006. On-site cytopathologic evaluation of the specimen adequacy was not available.

Three to four needle passes under real-time US on target nodules were used. The first pass consisted of capillary sampling, and specimens were placed on glass. Other passes used aspiration, and specimens were placed in a methanol-based, buffered transport solution.

An adequate specimen was defined as having five to six clusters of thyroid follicular cells. If the specimen contained no follicular cells, the researchers considered it nondiagnositic. If it contained insufficient follicular cells, it was suboptimal.

Overall, researchers were able to obtain adequate specimens in 92.6% of the 447 cases. Nondiagnostic specimens occurred in 3.6% of the 447 cases, and suboptimal specimens occurred in 3.8%.

Cytologists found that 4.5% of specimens were malignant. Atypical or suspicious features were found in 8.3% of specimens. A benign cytological diagnosis was made in 79.9% of 447 specimens, of which 1.1% were false-negative.

The Procedure

In the office-based setting, the need for the procedure generally arises when a patient comes in for a consultation with a surgeon, said Dr. Steward. The physician performs an initial diagnostic US and a US-guided FNAB using local anesthetic, and then sends specimens to a cytopathology lab, he said.

Pages: 1 2 3 | Single Page

Filed Under: Departments, Head and Neck, Medical Education, Practice Focus, Practice Management Tagged With: billing and coding, diagnosis, Imaging, patient satisfaction, research, surgery, thyroid, trainingIssue: February 2008

You Might Also Like:

  • In-Office Laryngeal Procedures in Awake Patients a Viable, and Often Preferable, Option
  • Which Ultrasound Classification System Is Best at Reducing Unnecessary Thyroid Nodule Biopsies?
  • Avoiding the Operating Room: The Advantages of Office-Based Laryngology and Esophagology
  • Many Laryngeal Biopsies Can Be Performed In-Office

Leave a Reply Cancel reply

Your email address will not be published. Required fields are marked *

The Triological SocietyENTtoday is a publication of The Triological Society.

Polls

Would you choose a concierge physician as your PCP?

View Results

Loading ... Loading ...
  • Polls Archive

Top Articles for Residents

  • Applications Open for Resident Members of ENTtoday Edit Board
  • How To Provide Helpful Feedback To Residents
  • Call for Resident Bowl Questions
  • New Standardized Otolaryngology Curriculum Launching July 1 Should Be Valuable Resource For Physicians Around The World
  • Do Training Programs Give Otolaryngology Residents the Necessary Tools to Do Productive Research?
  • Popular this Week
  • Most Popular
  • Most Recent
    • Excitement Around Gene Therapy for Hearing Restoration

    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment

    • Otolaryngologists Are Still Debating the Effectiveness of Tongue Tie Treatment

    • Keeping Watch for Skin Cancers on the Head and Neck

    • Is Middle Ear Pressure Affected by Continuous Positive Airway Pressure Use?

    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment

    • Rating Laryngopharyngeal Reflux Severity: How Do Two Common Instruments Compare?

    • Is Middle Ear Pressure Affected by Continuous Positive Airway Pressure Use?

    • Otolaryngologists Are Still Debating the Effectiveness of Tongue Tie Treatment

    • Complications for When Physicians Change a Maiden Name

    • Excitement Around Gene Therapy for Hearing Restoration
    • “Small” Acts of Kindness
    • How To: Endoscopic Total Maxillectomy Without Facial Skin Incision
    • Science Communities Must Speak Out When Policies Threaten Health and Safety
    • Observation Most Cost-Effective in Addressing AECRS in Absence of Bacterial Infection

Follow Us

  • Contact Us
  • About Us
  • Advertise
  • The Triological Society
  • The Laryngoscope
  • Laryngoscope Investigative Otolaryngology
  • Privacy Policy
  • Terms of Use
  • Cookies

Wiley

Copyright © 2025 by John Wiley & Sons, Inc. All rights reserved, including rights for text and data mining and training of artificial technologies or similar technologies. ISSN 1559-4939