Belmont M J, Wax M K, DeSouza F N
Department of Otolaryngology-HNS, State University of New York at Buffalo, Buffalo General Hospital, 14203, USA.
Head Neck. 1998 May;20(3):266-9. doi: 10.1002/(sici)1097-0347(199805)20:3<266::aid-hed12>3.0.co;2-i.
Large, compressive thyroid masses are usually removed as an elective procedure. Rarely is a patient's condition allowed to progress to severe respiratory distress before surgical intervention is recommended. When allowed to progress, management of the airway can be problematic.
A case report of a patient with a neglected thyroid lymphoma is presented.
The natural progression of the disease, leading to impending airway collapse, necessitated emergency management of the airway. Due to supraglottic edema and a large neck mass, traditional methods of securing the airway were not feasible. Initiation of femoral-femoral cardiopulmonary bypass, under local anesthesia, ensured adequate oxygenation and allowed a controlled tracheotomy to be performed.
The result obtained suggests that this approach provides a safe solution for airway control when intubation or a surgically created airway is either unsuccessful or too hazardous.
大型压迫性甲状腺肿块通常作为择期手术切除。很少会在建议进行手术干预之前让患者的病情发展到严重呼吸窘迫的程度。如果任其发展，气道管理可能会出现问题。
本文报告一例被忽视的甲状腺淋巴瘤患者的病例。
疾病的自然进展导致即将发生气道塌陷，因此需要对气道进行紧急处理。由于声门上水肿和颈部巨大肿块，传统的气道固定方法不可行。在局部麻醉下启动股-股体外循环，确保了充分的氧合，并允许进行可控的气管切开术。
所获得的结果表明，当插管或手术建立气道不成功或风险太大时，这种方法为气道控制提供了一种安全的解决方案。
