Difficult airway management and emergency tracheostomy in a patient with giant goiter presenting with respiratory arrest: A case report

Giant goiter is commonly asymptomatic or progresses with nonspecific symptoms, such as pain, hoarseness and dysphagia. In rare cases, enlargement of the thyroid may cause compression of the trachea and lead to life-threatening complications. As a result of iodization programs implemented throughout the world to address iodine deficiency disorders, giant goiter is rare today. Although not common, the disease may result in a difficult airway in cases of tracheal compression. The present study shares our experience of a giant retrosternal goiter in a patient presenting with respiratory arrest who underwent emergency tracheostomy after multiple attempts at orotracheal intubation and then thyroidectomy during an intensive care stay due to the development of tracheomalacia.

Intubation of a Patient with a Large Goiter: The Advantageous Role of Videolaryngoscopy

Fiberoptic bronchoscopy has long been considered the gold standard for patients who present with a difficult airway. In the case presented, a patient has a large palpable goiter and requires intubation. After the unsuccessful attempt to intubate with the use of fiberoptic bronchoscopy, the decision to switch to videolaryngoscopy afforded a positive result. We present this case to suggest that the utilization of videolaryngoscopy may be an alternative option for intubation when other methods have failed. It is imperative for anesthesiologists to understand the benefits that this modality may provide.