Airway Management of Retrosternal Goiters in 22 Cases in a Tertiary Referral Center

Yuanming Pan,1 Chaoqin Chen,1 Lingya Yu,2 Shengmei Zhu,1 Yueying Zheng1 1Department of Anesthesiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, People’s Republic of China; 2Department of Radiology, The First Affiliated Hospital, School of Med...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Pan Y, Chen C, Yu L, Zhu S, Zheng Y
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	airway management anesthesia retrosternal goiter postoperative tracheomalacia Therapeutics. Pharmacology RM1-950
Acceso en línea:	https://doaj.org/article/3334942cb2cd4fdb90e46690e58c140b
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:3334942cb2cd4fdb90e46690e58c140b
record_format	dspace
spelling	oai:doaj.org-article:3334942cb2cd4fdb90e46690e58c140b2021-12-02T11:57:17ZAirway Management of Retrosternal Goiters in 22 Cases in a Tertiary Referral Center1178-203Xhttps://doaj.org/article/3334942cb2cd4fdb90e46690e58c140b2020-12-01T00:00:00Zhttps://www.dovepress.com/airway-management-of-retrosternal-goiters-in-22-cases-in-a-tertiary-re-peer-reviewed-article-TCRMhttps://doaj.org/toc/1178-203XYuanming Pan,1 Chaoqin Chen,1 Lingya Yu,2 Shengmei Zhu,1 Yueying Zheng1 1Department of Anesthesiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, People’s Republic of China; 2Department of Radiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, People’s Republic of ChinaCorrespondence: Shengmei Zhu; Yueying ZhengDepartment of Anesthesiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 31003, People’s Republic of ChinaTel +86-13777408863Email 1507128@zju.edu.cnBackground: The present study aimed to investigate the incidence and extent of difficult airway management in patients with massive retrosternal goiter.Design: An 8-year retrospective analysis was performed to identify patients who underwent massive retrosternal thyroidectomy. A total of 22 cases were identified as giant retrosternal goiter, followed by a review of each patient’s preoperative computerized tomography imaging.Interventions: There were no cases of failed intubation. Twenty patients underwent uneventful tracheal intubation using direct laryngoscopy or Glidescope. Thirteen patients received a muscle relaxant intravenously, and two patients were induced with sevoflurane. Five patients underwent awake tracheal intubation, including awake fiberoptic intubation in three patients. Before entering the operating theatre, the remaining two patients underwent oral tracheal intubation with Glidescope in the emergency department.Results: Two patients had tracheal intubation before they entered the operating theatre. Once entering vocal cords, tracheal intubation can pass beyond the site of the tracheal obstruction without difficulty. One patient died because of serious perioperative bleeding owing to the adhesion between the retrosternal goiter and large vessel within the thoracic cavity. One patient experienced dyspnea after extubation and was intubated again.Conclusion: Intravenous induction of muscle relaxant using laryngoscopy or Glidescope is feasible in patients with massive benign retrosternal goiter. The incidence of difficult intubation and postoperative tracheomalacia is likely too rare. Furthermore, perioperative bleeding and postoperative airway complication seem frequent.Keywords: airway management, anesthesia, retrosternal goiter, postoperative tracheomalaciaPan YChen CYu LZhu SZheng YDove Medical Pressarticleairway managementanesthesiaretrosternal goiterpostoperative tracheomalaciaTherapeutics. PharmacologyRM1-950ENTherapeutics and Clinical Risk Management, Vol Volume 16, Pp 1267-1273 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	airway management anesthesia retrosternal goiter postoperative tracheomalacia Therapeutics. Pharmacology RM1-950
spellingShingle	airway management anesthesia retrosternal goiter postoperative tracheomalacia Therapeutics. Pharmacology RM1-950 Pan Y Chen C Yu L Zhu S Zheng Y Airway Management of Retrosternal Goiters in 22 Cases in a Tertiary Referral Center
description	Yuanming Pan,1 Chaoqin Chen,1 Lingya Yu,2 Shengmei Zhu,1 Yueying Zheng1 1Department of Anesthesiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, People’s Republic of China; 2Department of Radiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, People’s Republic of ChinaCorrespondence: Shengmei Zhu; Yueying ZhengDepartment of Anesthesiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 31003, People’s Republic of ChinaTel +86-13777408863Email 1507128@zju.edu.cnBackground: The present study aimed to investigate the incidence and extent of difficult airway management in patients with massive retrosternal goiter.Design: An 8-year retrospective analysis was performed to identify patients who underwent massive retrosternal thyroidectomy. A total of 22 cases were identified as giant retrosternal goiter, followed by a review of each patient’s preoperative computerized tomography imaging.Interventions: There were no cases of failed intubation. Twenty patients underwent uneventful tracheal intubation using direct laryngoscopy or Glidescope. Thirteen patients received a muscle relaxant intravenously, and two patients were induced with sevoflurane. Five patients underwent awake tracheal intubation, including awake fiberoptic intubation in three patients. Before entering the operating theatre, the remaining two patients underwent oral tracheal intubation with Glidescope in the emergency department.Results: Two patients had tracheal intubation before they entered the operating theatre. Once entering vocal cords, tracheal intubation can pass beyond the site of the tracheal obstruction without difficulty. One patient died because of serious perioperative bleeding owing to the adhesion between the retrosternal goiter and large vessel within the thoracic cavity. One patient experienced dyspnea after extubation and was intubated again.Conclusion: Intravenous induction of muscle relaxant using laryngoscopy or Glidescope is feasible in patients with massive benign retrosternal goiter. The incidence of difficult intubation and postoperative tracheomalacia is likely too rare. Furthermore, perioperative bleeding and postoperative airway complication seem frequent.Keywords: airway management, anesthesia, retrosternal goiter, postoperative tracheomalacia
format	article
author	Pan Y Chen C Yu L Zhu S Zheng Y
author_facet	Pan Y Chen C Yu L Zhu S Zheng Y
author_sort	Pan Y
title	Airway Management of Retrosternal Goiters in 22 Cases in a Tertiary Referral Center
title_short	Airway Management of Retrosternal Goiters in 22 Cases in a Tertiary Referral Center
title_full	Airway Management of Retrosternal Goiters in 22 Cases in a Tertiary Referral Center
title_fullStr	Airway Management of Retrosternal Goiters in 22 Cases in a Tertiary Referral Center
title_full_unstemmed	Airway Management of Retrosternal Goiters in 22 Cases in a Tertiary Referral Center
title_sort	airway management of retrosternal goiters in 22 cases in a tertiary referral center
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/3334942cb2cd4fdb90e46690e58c140b
work_keys_str_mv	AT pany airwaymanagementofretrosternalgoitersin22casesinatertiaryreferralcenter AT chenc airwaymanagementofretrosternalgoitersin22casesinatertiaryreferralcenter AT yul airwaymanagementofretrosternalgoitersin22casesinatertiaryreferralcenter AT zhus airwaymanagementofretrosternalgoitersin22casesinatertiaryreferralcenter AT zhengy airwaymanagementofretrosternalgoitersin22casesinatertiaryreferralcenter
_version_	1718394798774157312

Airway Management of Retrosternal Goiters in 22 Cases in a Tertiary Referral Center

Ejemplares similares