Delayed respiratory distress after thyroidectomy-another challenge for us: a case report

Area of Science:

• Surgical complications
• Airway management
• Endocrinology

Background:

• Delayed airway obstruction and severe dyspnea are rare, life-threatening postoperative complications following thyroidectomy.
• Prompt recognition and management are critical to prevent mortality.

Observation:

• A 47-year-old female developed worsening dyspnea, airway compromise, and neck inflammation ten days post-thyroidectomy, despite a tracheostomy.
• Decannulation on postoperative day six precipitated extensive neck infection, bilateral vocal fold immobility, and life-threatening airway obstruction due to a retained surgical gauze.
• The patient required emergency intubation and re-tracheostomy to secure the airway.

Findings:

• Retained surgical gauze in the peritracheal space led to severe neck infection and bilateral vocal fold immobility.
• Inappropriate decannulation in a compromised patient exacerbated airway obstruction.
• Successful airway management involved emergency intubation and re-tracheostomy.

Implications:

• Post-thyroidectomy dyspnea can occur even with a tracheostomy, necessitating vigilant monitoring.
• Expertise of the thyroid surgeon and careful postoperative decision-making are paramount in preventing fatal complications.
• Patients with postoperative complaints should be managed by the primary surgeon before referral to other specialists.