Gross tracheal deviation: airway challenges and concerns--two case reports

Area of Science:

• Anesthesiology
• Otolaryngology
• Endocrinology

Background:

• Difficult airway management poses challenges beyond standard algorithms.
• Large thyroid swellings (goiters) can cause airway distortion, endocrine, and metabolic issues.
• Perioperative complications are a concern in patients with extensive goiters.

Observation:

• Two patients with massive thyroid enlargement and significant tracheal deviation were analyzed.
• One patient also presented with retrosternal extension of the goiter.
• Both patients required surgical excision of their colloid goiter.

Findings:

• Successful airway management was achieved despite anatomical challenges.
• Specific anesthetic techniques and careful planning were crucial for patient safety.
• The study demonstrates feasible approaches to managing extreme airway compromise due to goiter.

Implications:

• This case series offers valuable insights for managing patients with large goiters and difficult airways.
• It underscores the importance of individualized airway management strategies.
• Findings can inform clinical practice and improve patient outcomes in similar complex cases.