Tracheal necrosis following two-stage thyroidectomy: A case report

Area of Science:

• Otolaryngology
• Endocrinology
• Surgical Pathology

Background:

• Thyroidectomy is a common surgical procedure.
• Tracheal necrosis is a known but rare complication, typically associated with invasive thyroid carcinoma requiring tracheal resection.
• Noninvasive thyroid carcinoma usually has a favorable prognosis without tracheal involvement.

Observation:

• A case of delayed tracheal necrosis occurred after a routine thyroidectomy for noninvasive papillary thyroid carcinoma.
• The complication was suspected to be secondary to a postoperative seroma.
• The patient's condition was successfully managed with a temporary tracheostomy.

Findings:

• This case highlights that tracheal necrosis can occur as a delayed complication even in the absence of invasive carcinoma or direct tracheal resection.
• Postoperative seroma formation may play a role in the pathogenesis of tracheal necrosis following thyroidectomy.
• Conservative management, including temporary tracheostomy, can be effective in resolving this rare complication.

Implications:

• The findings suggest a need for vigilance regarding potential tracheal complications, even in seemingly straightforward thyroidectomy cases.
• Awareness of seroma formation as a potential risk factor for tracheal necrosis is important for surgeons.
• This case broadens the understanding of the etiology and management of post-thyroidectomy tracheal complications.