Airway management of a huge thyroid mass: A case report

Abstract

In large thyroidal masses with excessive tracheal shift, the laryngeal opening is usually in the normal position and intubation may not be difficult. However, in some cases, such as retrosternal big thyroid glands, airway management can get challenging. Failure to successfully manage difficult airways is responsible for 30% of deaths attributed to anesthesia, with approximately 600 deaths annually. Successful awake intubation can be performed in 88-100% by considering the appropriate position and experience of anesthesiologist with a fiberoptic bronchoscope. However, the path to be followed should be determined according to each patient.

Keywords

• Difficult airway
• Fiberoptic
• Huge goiter
• Entubation

Dev tiroidal kitlede havayolu yönetimi: Olgu sunumu

Öz

Özellikle retrosternal guatra bağlı olarak, trakea üzerine bası yapan büyük tiroidal kitleler nedeniyle havayolu kontrolü zor olabilir. Aşırı trakea kayması olan büyük tiroidal kitlelerde bile laringeal açıklık genellikle normal pozisyonda olup, entübasyon zor olmayabilir. Zor havayolu yönetimini başarı ile yönetememek, yıllık yaklaşık 600 ölümle birlikte anesteziye atfedilen ölümlerin % 30‘undan sorumludur. Fiberoptik bronkoskop ile uygun pozisyon ve anestezi uzmanının tecrübesine de bakılarak %88-100’ünde başarılı uyanık entübasyon yapılabilir. Ancak izlenecek yol, her hasta için hastaya göre belirlenmelidir.

Anahtar Kelimeler

• Zor havayolu
• Fiberoptik
• Dev Guatr
• Entübasyon

Kaynakça

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