Tracheal collapse after thyroidectomy

Green, W. E. R.; Shepperd, H. W. H.; Stevenson, H. Michael; Wilson, W. James

doi:10.1002/bjs.1800660811

Cited by 39 publications

(22 citation statements)

References 18 publications

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“…Tracheomalacia is an uncommon complication in a patient undergoing thyroidectomy and occurs in 0.1 to 0.5% [12]. However in patients with massively enlarged goiter the risk is relatively higher [7,12].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…However in patients with massively enlarged goiter the risk is relatively higher [7,12]. The major concern is that it may cause life threatening post operative airway obstruction with the recorded mortality of 44% [12,13]. Its mechanical effect usually results from compression by the surrounding goiter leading to softening of the tracheal cartilage [12,13].…”

Section: Discussionmentioning

confidence: 99%

“…The major concern is that it may cause life threatening post operative airway obstruction with the recorded mortality of 44% [12,13]. Its mechanical effect usually results from compression by the surrounding goiter leading to softening of the tracheal cartilage [12,13]. The trachea may collapse immediately following extubation or as late as 48 hours into the postoperative period.…”

Section: Discussionmentioning

confidence: 99%

“…However tracheostomy may be needed in situation were the trachea collapses post tumour removal [7]. Tracheostomy has been reported to have been performed in 6% (59/964) of patients following thyroidectomies [18], the indication primarily being intraoperative tracheal deformity with narrowing (more than 50%) of tracheal circumference on radiology and gland adherence to the tracheal wall or tracheomalacia [12,18].…”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

Thyroidectomy for Massive Goiter Weighing more than 500 Grams. Technical Difficulties, Complications and Management. Review

Machado¹

2011

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Background: Multinodular goiter is a relatively common thyroid disorder with a marked female preponderance. Most of these goiters weigh less than 100 grams with those weighing more than 500 grams being exceptional. The massively expanding goiter due to the strategic anatomic location of thyroid gland, in addition to being cosmetically disfiguring can seriously compromise the patency of the trachea and oesophagus. Thyroidectomy for such goiters is a surgical challenge due to the possible association of tracheomalacia, retrosternal extension, skin involvement and the difficulty in intubation and dissection of the thyroid gland due to distorted and displaced anatomy. Material and methods: While presenting 2 patients who underwent thyroidectomy for glands weighing more than 500 grams, the literature is reviewed to analyze the technical difficulties and approach in such patients and the frequently encountered complications in them and their management. Results: A review of the literature revealed an additional 7 cases of patients who had undergone thyroidectomy for glands weighing more than 500 grams. Massively enlarged goiter was often associated with tracheomalacia, tracheal stenosis and retrosternal extension. Difficulty during surgery was most often encountered in establishing the airway and in exposure of the gland particularly when the skin was involved. The predominant postoperative complications were related to respiratory distress as a consequence of tracheomalacia and tracheal stenosis. Conclusion: In spite of the technical challenge related to the airway, and thyroidectomy, surgery continues to be the best option in experienced hands due to its distinct advantage of its immediate effect and complete resolution of compressive symptoms.

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Section: Discussionmentioning

confidence: 99%