Difficult airway challenges-intubation and extubation matters in a case of large goiter with retrosternal extension

Raval, C; Rahman, Saif Ur

doi:10.4103/0259-1162.152421

Cited by 7 publications

(8 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…WHO has classified goiter according to the size in which Class 0 - palpable mass within the neck structure, Class I - visible, palpable and undermines the curves and the neckline, Class II - a very large goiter with retrosternal extension that makes the tracheal deviation, compression of trachea, and esophagus. [ 4 ] Our patient comes under Class II type goiter.…”

Section: Discussionmentioning

confidence: 99%

“…If the size of thyroid swelling is small, airway examination is normal, and there is no tracheal compression or deviation we can proceed for a conventional airway management. [ 4 ] The concept of AFOI is not clearly defined, and it depends mainly on personal preferences. [ 6 ] Our patient was a case of large multinodular goiter, with airway difficulty and tracheal compression.…”

Section: Discussionmentioning

confidence: 99%

“…[ 3 ] In addition to endocrine and metabolic defects, the substernal extension of mass makes the airway management more difficult. [ 4 ] The invention of fiberoptic bronchoscope and the method of awake fiberoptic intubation (AFOI) is a milestone in the history of anesthesia to manage difficult airway. It is a technique which allows a flexible oral/nasal route to provide a clear visualization of vocal cords and subsequent passage of an endotracheal tube (ETT) into the trachea under direct vision.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Airway considerations in case of a large multinodular goiter

Kaur

Kataria

Muthuramalingapandian

et al. 2017

Anesth Essays Res

View full text Add to dashboard Cite

Patients with large goiters pose a great challenge to the anesthesiologist regarding securing the airway without compromising the safety of the patient. The technique of intubation depends on the choice and expertise of anesthesiologist. Awake fiberoptic intubation (AFOI) is the preferred technique. We present the case of large multinodular goiter with difficult airway in which AFOI was successfully used to secure the airway. Proper assessment, planning, and preparation for airway management should be done preoperatively to ensure patient safety.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Airway considerations in case of a large multinodular goiter

Kaur

Kataria

Muthuramalingapandian

et al. 2017

Anesth Essays Res

View full text Add to dashboard Cite

show abstract

“…Airway management in large goiter is always challenging due to 3,4 varying degrees of tracheal compression and deviation. Presence of mass anterior to trachea may hinder surgical airway access like tracheostomy or cricothyroidotomy.…”

Section: Casementioning

confidence: 99%

Novel Techniques for Difficult Airway Management in Various Clinical Scenarios: Case Series and Review of Literature

Patro

Kumar

Goyal

et al. 2020

ijsr

View full text Add to dashboard Cite

Difficult airway management has till date been the most fearsome and challenging part of any anaesthetic management. Meticulous planning is always done prior to anaesthetic induction of such patients with multiple back up plans and rescue strategy. Significant advancements in terms of clinical protocols, techniques, and devices / gadgets in this field have led to decreased incidence of airway related complications. We hereby present a case series of 3 clinical cases with different airway scenarios; 1) Patient with huge goiter, who was intubated with the help of an indigenously developed fish mouth valve device, 2) a temporomandibular joint ankylosis case, managed with awake fibreoptic guided intubation 3) Patient with post burn contracture of face and neck, in which fibreoptic intubation was performed after partial release of scar under tumescent anaesthesia. Extensive preoperative airway evaluation and preparation to handle any emergency by multiple backup plans always helps in smooth sailing through these difficult clinical scenarios

show abstract

“…[1235] Most of the information concerning anesthetic management is limited to isolated case reports and small case series. Review of recently published literature unearthed several controversies, with conflicts of opinion among experts regarding the best primary airway management to the extent that some advocates techniques that are totally condemned by others.…”

Section: Introductionmentioning

confidence: 99%

Airway management in patients with tracheal compression undergoing thyroidectomy: A retrospective analysis

Sajid

2017

Anesth Essays Res

View full text Add to dashboard Cite

Background:Airway management in large and retrosternal goiters with tracheal compression is often fraught with challenges and is a source of apprehension among anesthesiologists globally.Aims:In this study we attempt to delineate the preferred techniques of airway management of such cases in our institution and also to assess whether airway management was unnecessarily complicated.Setting and Design:Retrospective analysis.Materials and Methods:A retrospective review was conducted of thyroidectomies performed in our institution over a three year period from January 2013. Clinical, radiological, pathological, anesthetic and surgical data were obtained from hospital case records.Statistical Analysis:Qualitative data is represented as frequencies and percentages and quantitative data as mean and standard deviation.Results:Of 1861 thyroidectomies tracheal compression were present in 50 patients with minimum tracheal diameter ranging from 4-12mm (mean 7.84); with majority(95%) having a benign pathology. Critical tracheal compression (≤5 mm) was observed in four patients. Conventional intravenous induction and intubation under muscle relaxant was performed in majority (64%) of these patients. The rest of the cases (n=18) were intubated while preserving spontaneous ventilation after induction. Primary technique of airway management was reported successful in all cases with no instances of difficult ventilation or intubation. Postoperative morbidity in few cases resulted from hematoma (n=1), recurrent laryngeal nerve palsy (n=1), tracheomalacia (n=1) and pulmonary complications (n=2).Conclusion:Airway management in patients with tracheal compression due to benign goiter is quite straightforward and can be managed in the conventional manner with little or no complications.

show abstract

Difficult airway challenges-intubation and extubation matters in a case of large goiter with retrosternal extension

Cited by 7 publications

References 13 publications

Airway considerations in case of a large multinodular goiter

Airway considerations in case of a large multinodular goiter

Novel Techniques for Difficult Airway Management in Various Clinical Scenarios: Case Series and Review of Literature

Airway management in patients with tracheal compression undergoing thyroidectomy: A retrospective analysis

Contact Info

Product

Resources

About