Anesthetic Management of Retrosternal Thyroid A Case Report

Abstract

Airway management during thyroidectomy for retrosternal goitre is most often a challenge. It can contribute to adverse events intraoperatively and postoperatively. Here we describe the anesthetic management of a patient with long standing retrosternal goitre. The patient also had compression of trachea and total thyroidectomy was advised. Patient underwent awake nasal fiber optic intubation under topical anesthesia and sedation. The entire thyroid tissue including the retrosternal thyroid was removed through the neck. This case report suggests that Awake fiberoptic intubation (FOI) under topical anesthesia can be considered in patients with retrosternal goitre. Difficult airway should always be anticipated. The success of awake intubation depends on good communication along with psychological and pharmacological preparation of the patient. The primary principle should be a patient tailored approach keeping in mind the comorbidities and clinical status of the patient.