The incidence of difficult intubation in 2 000 patients undergoing thyroid surgery: A single center experience

Kalezić, Nevena; Milosavljevic, Radoje; Paunović, Ivan; Živaljević, Vladan; Diklić, Aleksandar; Matić, Danica; Ivanović, Branislava; Nešković, Vojislava

doi:10.2298/vsp0905377k

Cited by 25 publications

(26 citation statements)

References 12 publications

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“…Although both study groups included more females, DI was significantly more prevalent in men, which is consistent with the results of our previous study 10 . Results reported by Bouaggad et al 5 are in accordance with our results.…”

Section: Nevena Kalezić Et Alsupporting

confidence: 91%

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Predictors of Difficult Airway Management in Thyroid Surgery: A Five-Year Observational Single-Center Prospective Study

Kalezić

2016

ACC

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SUMMARY -Difficult tracheal intubation (DI) is more common in thyroid than in other surgical branches due to thyromegaly. Proper preoperative airway evaluation is necessary in order to reduce the potential numerous complications. The study examined the incidence of DI in thyroid surgery and the influence of tracheal dislocation and other risk factors on DI. A prospective study was conducted on 2379 patients who underwent thyroidectomy at the Center for Endocrine Surgery, Clinical Center of Serbia, from 2007 to 2012. Patients were divided into groups with (n=162) and without DI (n=2217). Besides tracheal dislocation, another 13 risk factors contained in 13 screening tests and three additional factors of gender, age and diagnosis were defined. The incidence of DI in our study was 6.81%. The presence of tracheal dislocation was statistically significant, but not an independent predictor of DI. The diagnosis, large circumference and small neck length, previous DI, recessive mandible, tooth characteristics and oral anomalies were the most significant and independent predictors of DI. Neck circumference and small neck length had highest sensitivity. Previous DI had highest specificity. Thyromegaly, if causing tracheal dislocation and/or stenosis, represents a significant DI predictor, not individually, but in combination with other factors.

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Section: Nevena Kalezić Et Alsupporting

confidence: 91%

“…The incidence of DI was 6.81%. In our previous study 10 on 2000 patients undergoing thyroid surgery, the incidence was 5.5%. A similar incidence (5.3%) was demonstrated in a study by Bouaggad et al 5 .…”

Section: Discussionmentioning

confidence: 93%

Predictors of Difficult Airway Management in Thyroid Surgery: A Five-Year Observational Single-Center Prospective Study

Kalezić

2016

ACC

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“…However, they found an increased incidence of difficult intubation when malignant thyroid was present. Although there is a claim that big goitres are associated difficult airway [15] based on the assumption that, big goitres dislocate the trachea. Our conclusion is in line with that of Bouaggad et al in that presence of big goitres is not always associated with deformity leading to difficult airway.…”

Section: Discussionmentioning

confidence: 99%

“…The study concluded that DI was highest in patients with polynodal goiter but extreme DI was present mostly in patients with hyperthyroidism and men seem to be at higher risk for DI than women [15].…”

Section: Introductionmentioning

confidence: 97%

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Magnitude and Predictive Factors of Difficult Airway in Patients Undergoing Thyroid Surgery, From a Goiter Endemic Area

Hailekiros¹,

Abiy²

2015

J Anesth Clin Res

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The role of an enlarged goiter for the airway management in patient populations undergoing thyroidectomy has rarely been studied. The main objective of this study was to assess the incidence and predictive factors of difficult airway in patients undergoing thyroidectomy. The study was designed as a prospective observation carried out to determine the incidence of difficult mask ventilation, difficult laryngoscopy, difficult intubation and failed intubation. Association of goiter related variables and demographic characteristics association with difficult airway was analyzed using chi-square, fisher's exact taste and binary logistic regression with odds ratio and 95% CI in the univariate analysis. Sensitivity, specificity positive predictive value and negative predictive value for bedside airway parameters were calculated. For the preoperative bedside airway parameters Roc analysis with a CI of 95% and p-value 40 years), deviation of the trachea (>1 cm on chest x-ray), jaw slide (B or C), mouth opening (<3 cm) were identified as a potential risk factors in the univariate analysis. With multivariate analysis tracheal deviation was identified as the only independent risk factor for DL or DI. Patients with DL (CL III/IV) required repeated attempts of laryngoscopy (≥ 3) for intubation. The use of smaller size endotracheal tubes was helpful in managing patients in who calculated size ETT were difficult to pass through a narrowed or deviated trachea. We conclude that thyroid enlargement accompanied by airway deformity constitutes a risk factor for both difficult laryngoscopy and intubation. Preparation of different size endotracheal tubes as well as ordering a preoperative chest x-ray is recommended.

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General Preoperative Workup, Informed Consent, Antibiotic Prophylaxis, and Anesthesia in Thyroid Surgery

Gurrado,

Sgaramella,

Poli

et al. 2023

Updates in Surgery

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The incidence of difficult intubation in 2 000 patients undergoing thyroid surgery: A single center experience

Abstract: The incidence of DI was higest in patients with polynodal goiter but extremly DI was present mostly in patients with hyperthiroidism. Men seem to be at higher risk for DI than women. Scoring system used in this study for prediction of DI may be useful in this patient population.

Cited by 25 publications

References 12 publications

Predictors of Difficult Airway Management in Thyroid Surgery: A Five-Year Observational Single-Center Prospective Study

Predictors of Difficult Airway Management in Thyroid Surgery: A Five-Year Observational Single-Center Prospective Study

Magnitude and Predictive Factors of Difficult Airway in Patients Undergoing Thyroid Surgery, From a Goiter Endemic Area

General Preoperative Workup, Informed Consent, Antibiotic Prophylaxis, and Anesthesia in Thyroid Surgery

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