In general, whether thyroid nodules that have remained unchanged for 4 years of observation require treatment needs to be analyzed on a case-by-case basis. If the nodule is still asymptomatic and there are no abnormalities in the thyroid function, regular review is sufficient. Generally speaking, if the thyroid nodule is small and has remained unchanged for 4 years, it is likely to be benign and does not require special treatment. However, the fact that it has remained unchanged for a few years does not mean that it will remain unchanged after that time, so it is still necessary to undergo regular checkups to review the specifics of the nodule in order to prevent it from suddenly changing into a malignant nodule. On the other hand, if the nodules are malignant, medication or surgery will still be needed, so it is not possible to generalize. It is advisable to consult a professional doctor to determine whether treatment is needed, taking into account your own condition and the results of a more comprehensive examination.