Alawadhi Retaj, Alsairefi Sood, Bhat Imtiyaz N, Kachroo Javeed I, AlMutairi Mishal M
Medicine and Surgery, Royal College of Surgeons in Ireland, Dublin, IRL.
Otolaryngology-Head and Neck Surgery, Farwaniya Hospital, Al Farwaniyah, KWT.
Cureus. 2025 Mar 28;17(3):e81374. doi: 10.7759/cureus.81374. eCollection 2025 Mar.
Supraglottic edemas are rare complications of severe hypothyroidism that present significant challenges in management due to their critical location and acute clinical manifestations. The traditional approach of managing hypothyroidism and airway support has been the preferred treatment in the case of supraglottic edema, while glucocorticoids have a controversial therapeutic benefit. Here, we present a case of a 59-year-old male patient with a history of hypothyroidism and pituitary adenoma resection who presented to the emergency department with stridor and shortness of breath, where he underwent ICU admission, was sedated, and received medical treatments. The pre-ICU fiberoptic evaluation suggested supraglottic edema and congestion of the nasopharynx, and neck imaging revealed an inflammatory process of the right side of the oropharynx and right palatine tonsil and ruled out the presence of an abscess in deep neck spaces. Intensive care unit stay and the multidisciplinary treatments were beneficial, resulting in complete remission of the supraglottic edema and the subsequent symptoms. This case highlights the manifestation of supraglottic edema as a complication of hypothyroidism post pituitary adenoma resection and emphasizes the importance of multidisciplinary collaboration in achieving successful outcomes of these challenging presentations.
声门上水肿是严重甲状腺功能减退症的罕见并发症,因其关键位置和急性临床表现,在治疗上存在重大挑战。对于声门上水肿,传统的甲状腺功能减退症管理和气道支持方法一直是首选治疗方式,而糖皮质激素的治疗益处存在争议。在此,我们报告一例59岁男性患者,有甲状腺功能减退症和垂体腺瘤切除病史,因喘鸣和呼吸急促就诊于急诊科,随后入住重症监护病房(ICU),接受镇静及药物治疗。入住ICU前的纤维喉镜检查提示声门上水肿和鼻咽部充血,颈部影像学检查显示口咽右侧和右侧腭扁桃体有炎症过程,排除了深部颈部间隙脓肿的存在。在ICU的治疗及多学科治疗取得了良好效果,声门上水肿及后续症状完全缓解。该病例突出了垂体腺瘤切除术后甲状腺功能减退症并发声门上水肿的表现,并强调了多学科协作对于成功治疗这些具有挑战性病例的重要性。