Thyroid Storm in Head and Neck Emergency Patients

Area of Science:

• Endocrinology
• Emergency Medicine
• Head and Neck Surgery

Background:

• Thyroid storm is a rare, life-threatening endocrine emergency.
• Limited literature exists on thyroid storm in head and neck trauma and surgery.
• Diagnosis is challenging due to rarity, often leading to misdiagnosis and delayed management.

Purpose of the Study:

• To compile and analyze existing literature on thyroid storm in head and neck trauma/surgery patients.
• To develop a consensus and augment knowledge on this rare condition.
• To improve diagnosis and management strategies.

Main Methods:

• A comprehensive 30-year literature search was conducted across major databases (PubMed/MEDLINE, EMBASE, CINAHL, Science Citation Index).
• MeSH terms for thyroid storm were utilized.
• Statistical analyses were performed on the reviewed articles.

Main Results:

• Seven cases of thyroid storm in head and neck trauma/surgery patients were reviewed.
• Most patients (85.7%) required medical management; one (14.3%) needed adjunctive surgery.
• Diagnosis was often delayed, with 71.4% not diagnosed on the first hospital day; Burch and Wartofsky criteria were used in 42%.

Conclusions:

• Early recognition of thyroid storm in head and neck patients significantly reduces morbidity and mortality.
• Thyroid storm should be considered and ruled out in symptomatic head and neck trauma or post-surgery patients, even if unexpected.