Anaesthesia and surgical aspects of thyroid swelling: the Ibadan experience

Seventy-five cases of thyroid swelling operated on at the University College Hospital, Ibadan over a period of two years and three months (March 1990 - May 1993) were reviewed. The male-female ratio was 1:8.6, and the highest incidence was in the fourth decade (34.7%). Benign nodular and multinodular goitre constituted 80%, solitary adenoma constituted 6.7%, papillary carcinoma constituted 4% and toxic goitre 9.3%. Approximately 20% presented with a duration of over 5 years, and 22.7% of the glands removed weighed over 100 gms. Eighteen of the cases (24%) showed tracheal deviation, but this did not cause preoperative respiratory problems although there were difficulties in endotracheal incubation during anaesthesia. The non-toxic benign goitres were totally asymptomatic regardless of their size, and the indication for surgery was for cosmetic reasons. We did not routinely search for the recurrent laryngeal nerve and we did not routinely dissect out the inferior thyroid artery for ligation at its main trunk.