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Updated: May 11, 2026
04:09
Minimal Invasive Resection of Large Retrosternal Thyroid Goiter
Published on: September 20, 2024
Anaesthesia for massive retrosternal thyroidectomy in a tertiary referral centre
G A Dempsey1, J A Snell, R Coathup
1Department of Anaesthesia and Critical Care and.
British Journal of Anaesthesia
|May 22, 2013
Summary
Massive retrosternal goitre (RSG) managed in specialized head and neck units rarely causes difficult tracheal intubation or ventilation. However, surgical complications like recurrent laryngeal nerve injury are more common.
Area of Science:
- Anesthesiology
- Otolaryngology
- Thoracic Surgery
Background:
- Retrosternal goitre (RSG) is an uncommon condition presenting anesthetic challenges.
- Traditional teaching emphasizes difficult airway management in RSG patients.
- The actual incidence of these anesthetic complications is not well-defined.
Purpose of the Study:
- To review anesthetic management of patients with massive RSG undergoing thyroidectomy.
- To determine the incidence of airway management difficulties and surgical complications.
Main Methods:
- Retrospective review of anesthetic records and CT imaging.
- Analysis of patients with massive RSG (extending to aortic arch or beyond) undergoing thyroidectomy.
- Data collected from January 2007 to May 2012 at University Hospital Aintree.
Main Results:
- 19 patients with massive RSG identified from 573 thyroidectomies.
- One failed intubation; all others had uneventful direct laryngoscopy.
- No sternotomy required; no postoperative respiratory issues or tracheomalacia.
- Three cases of recurrent laryngeal nerve (RLN) injury reported.
Conclusions:
- Massive RSG managed in a dedicated head and neck unit has a low incidence of difficult tracheal intubation, ventilation, or postoperative respiratory issues.
- Surgical complications, particularly RLN injury and postoperative bleeding, are more frequent than with standard cervical thyroidectomy.
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