Tracheoesophageal complications of thyroid disease

Fine needle aspiration (FNA) biopsy in thyroid diagnosis has significantly reduced the need for diagnostic thyroidectomy. The relative proportion of therapeutic thyroid surgery is therefore increasing and, since a significant number of therapeutic procedures are indicated to alleviate tracheoesophageal complications, surgeons are likely to be confronted with an increasing percentage of potentially challenging cases in the face of declining thyroidectomy caseloads. All thyroidectomies done at the authors' institution from 1987 through 1990 were studied in order to assess the potential impact of FNA on thyroid surgery and to specifically analyze the management of those cases accompanied by tracheoesophageal complications. It is concluded that 18% of the 87 thyroidectomies in this series could possibly have been avoided had FNA been obtained routinely. The clinical manifestations and surgical management of those cases associated with tracheoesophageal complications are presented. General therapeutic strategies for such cases are also summarized.