Marques Beatriz, Oliveira Rita, Ameiro Roberto J, Paiva Manuela
Department of Anaesthesiology, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, PRT.
Cureus. 2024 Feb 26;16(2):e54933. doi: 10.7759/cureus.54933. eCollection 2024 Feb.
Airway complications account for a significant amount of post-thyroidectomy complications. Forgotten goiter is a residual thyroid mass left after total thyroidectomy, an event already depicted in the literature. Clinical presentation is diverse, ranging from asymptomatic tracheal deviation to symptoms caused by hormonally active thyroid tissue or airway obstruction due to mass effect. However, it has never been documented as the cause of acute respiratory distress following thyroid surgery. We report the case of a 65-year-old female undergoing left hemithyroidectomy due to long-standing substernal goiter. Anesthesia induction and surgery were uneventful. On extubation, the patient presented with acute respiratory distress requiring prompt airway management. A computed tomography scan revealed residual intrathoracic goiter resulting in significant airway compression. Therefore, although a rare event, a forgotten goiter should be considered by a multidisciplinary team when patients undergoing surgery for substernal goiter develop acute postoperative airway obstruction after common post-thyroidectomy complications have been excluded.
气道并发症在甲状腺切除术后并发症中占相当比例。隐匿性甲状腺肿是全甲状腺切除术后残留的甲状腺肿块，这一情况在文献中已有描述。其临床表现多样，从无症状的气管偏移到由具有激素活性的甲状腺组织引起的症状，或因肿块效应导致的气道阻塞。然而，它从未被记录为甲状腺手术后急性呼吸窘迫的原因。我们报告一例65岁女性因长期胸骨后甲状腺肿接受左半甲状腺切除术的病例。麻醉诱导和手术过程顺利。拔管时，患者出现急性呼吸窘迫，需要立即进行气道管理。计算机断层扫描显示残留的胸内甲状腺肿导致严重气道受压。因此，尽管是罕见事件，但当因胸骨后甲状腺肿接受手术的患者在排除常见的甲状腺切除术后并发症后出现急性术后气道阻塞时，多学科团队应考虑隐匿性甲状腺肿的可能性。
