Anesthesia for Thyroid Surgery

Total Thyroidectomy Versus Hemi-Thyroidectomy in Management of Follicular Lesion Thyroid Nodule

“…Airway assessment is the second most important aspect in pre-operative assessment for thyroid surgery. To avoid the situation of an airway emergency, it is very important to do thorough airway assessment in the pre-operative period [12] .…”

“…While operating a hyperthyroid adenoma or Graves' disease, it is best to divide the muscle and avoid unnecessary handling of the gland. Needless to say, the various out flow channels for blood should be ligated at the earliest [10,12] .…”

“…The ipsilateral strap muscles (sternothyroid and sternohyoid) are grasped, retracted laterally and dissected off the anterior aspect of the thyroid gland using blunt dissection down to the level of the internal jugular vein along the entire length of the thyroid from the superior to inferior pole. If one should decide to divide the strap muscles, it is done at the level of the cricoid cartilage above the insertion of ansa cervicalis into the straps muscles which enters inferiorly [10,12] .…”

“…The key here is again adequate exposure and ligating the superior thyroid vessels by skeletonizing each. This avoids injury to the external branch of the superior laryngeal nerve whatever may be the course of the nerve [12] . Once the superior pole is fully mobilized, the thyroid gland can be mobilized anteriorly and medially out of the operative wound.…”

“…The superior parathyroid gland is frequently adherent to the posterior capsule of the thyroid near the tubercle of Zuckerkandl. A plane between the thyroid capsule and the superior parathyroid gland should be created, permitting the parathyroid gland to be swept off the thyroid out of the operative field while preserving its blood supply, which typically comes from the inferior thyroid artery [10,12] .…”