Delayed Multifocal Tracheal Injury Following Thyroidectomy: A Case Report and Review of the Literature

Cervical pneumatocele: A case report and review of the literature

A thyroidectomy is a safe and low-risk procedure done for a wide variety of thyroid disorders. Complications of a thyroidectomy are commonly due to damage of structures adjacent to the thyroid gland. In this case report, we present the case of a 39-year-old patient with a cervical pneumatocele a month after thyroidectomy for thyroid papillary carcinoma. The symptoms included neck swelling when speaking that resolved with rest. A follow-up neck CT scan found a collection of air anterior to the trachea most compatible with cervical pneumatocele. Exploratory surgery ensued and a pneumatocele arising from a tracheal subcutaneous fistula was cauterized. On follow-up laryngoscopy a month later, no further complications were found, and the patient reported resolution of symptoms. Tracheal injury following thyroidectomy is a rare complication and CT imaging can be helpful in diagnosing these complications and expediting management.

Tracheal injury following robotic thyroidectomy: A literature review of epidemiology, etiology, diagnosis, and treatment and 3 case reports

Robotic thyroidectomy is one of the most advanced surgical procedures used to manage benign and malignant thyroid nodules. However, complication risks such as tracheal injury still exists. Tracheal injury in robotic thyroidectomy is difficult to detect and is one of the life-threatening complications. This study reviews the current literature on the tracheal injury following robotic thyroidectomy and also discusses our findings on 2060 cases of robotic thyroidectomy via Da Vinci Surgical System performed in our department and finally presents 3 cases treated in our center. PubMed and Web of Science database were searched using Medical Subject Headings (Mesh) related to "tracheal injury" and "robotic thyroidectomy". The search was conducted without publication date limits. We reviewed the literature and summarized common causes, diagnosis and therapeutic options of tracheal injury in robotic thyroidectomy, which has been described in comparison studies or retrospective studies. Tracheal injury is often diagnosed when patients suffer from dyspnea and usually leads to severe postoperative consequences. Tracheal injury can be suspected in all patients having subcutaneous emphysema, pneumomediastinum, pneumothorax or dyspnea after robotic thyroidectomy. Tracheoscopy is necessary to determine the location and size of tracheal injury. In patients whose condition is stable and the injury is contained, conservative treatment is feasible. Certainly, primary closure or tracheotomy is necessary for patients with serious respiratory difficulty or pneumothorax.