Coping with respiratory obstruction after thyroidectomy for giant goitres in northern Nigeria.

Thyroidectomy for giant goitres in Northern Nigeria is associated with a high incidence of postoperative asphyxia. Tracheostomy may be a life saving procedure in these circumstances, but delay may prove fatal when its need arises insidiously. It is therefore better established prophylactically in patients who are more than likely to develop asphyxia, as in the case of preoperative complications followed by prolonged surgery. During the dry, dust-laden and desiccating Harmattan season of Northern Nigeria, however, tracheostomy poses life-threatening dangers and should be established only in patients who need it for survival. Postoperative asphyxia can be minimised by adopting certain operative techniques which reduce the risks of postoperative haematoma and laryngeal oedema. Establishment of a thyroidectomy team for surgery and for postoperative management improves results.