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Indian Journal of Anesthesia and Analgesia 11(2):p 103-108, April - June 2024. | DOI: https://doi.org/10.21088/ijaa.2349.8471.11224.10
Case Report
Anaesthetic Management in Retrosternal Extended Multinodular Goitre: A Comprehensive Approach
Syed Hazarath Nabi, Vishnuvardhan V, Abhinaya Manem, Suresh Kumar N
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Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
Indian Journal of Anesthesia and Analgesia 11(2):p 103-108, April - June 2024. | DOI: https://doi.org/10.21088/ijaa.2349.8471.11224.10
How Cite This Article:
Nabi SH, Vishnuvardhan V, Manem A, et al. Anaesthetic management in retrosternal extended multinodular goitre: a comprehensive approach. Ind J Anesth Analg. 2024;11(2):103-8.Timeline
Received : December 09, 2023
Accepted : February 01, 2024
Published : June 29, 2024
Abstract
Background: Multinodular goitre (MNG) is a common thyroid disorder distinguished by the presence of multiple nodules within the thyroid gland. As a result of gradual progressive development or a rapid nodular haemorrhage leads to tracheobronchial constriction resulting in development of dyspnoea and stridor. Compression of vascular systems can result in vena cava superior syndrome, which includes face and upper body oedema and ultimately postural collapse. Case Report: A 48-year-old female with multinodular goitre that increased in size over the course of four years and difficulty in swallowing and breathlessness with exertion since a year, with increasing severity in symptoms in the past 2 months. A computed tomography scan of the neck reveals a significant enlargement of the bilateral lobes and isthmus of the thyroid gland across both sides of the neck, extending retrosternally and medially compressing the trachea with significant luminal narrowing. Awake fibreoptic intubation for securing the airway and fibreoptic guided extubation performed by assessing the functioning of vocal cords and confirming absence of tracheomalacia. Conclusion: Proper preoperative airway examination, patient preparedness for airway management through flexible fibreoptic bronchoscopy or invasively if necessary, and closed perioperative and postoperative surveillance are critical to optimal results.
References
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- 2. Bhatnagar V, KarmarkarAA,S.Raghuvanshi VP.Anesthetic management of a patient with multinodular goiter with retrosternal extension presenting with obstructive sleep apnea for total thyroidectomy. Med J DY Patil Vidyapeeth 2018; 11:423-6.
- 3. Choudhary N, Kumar A, Wadhawan S, Bhadoria P, Panwar V. Retrosternal goitre: Anaesthetic implications and management. Indian J Clin Anaesth. 2018;5(3):453-456.
- 4. Gupta, Babita; Kohli, Santvana; Farooque, Kamran1; Jalwal, Gopal; Gupta, Deepak2; Sinha, Sumit2; Chandralekha, Topical airway anesthesia for awake fibreoptic intubation: Comparison between airway nerve blocks and nebulized lignocaine by ultrasonic nebulizer. Saudi Journal of Anaesthesia 2014; 8; S15-S19.
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Funding
This research received no funding.
Author Contributions
All authors contributed significantly to the work and approve its publication.
Ethics Declaration
This article does not involve any human or animal subjects, and therefore does not require ethics approval.
Acknowledgements
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Conflicts of Interest
The authors report no conflicts of interest in this work.
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Cite this article
Nabi SH, Vishnuvardhan V, Manem A, et al. Anaesthetic management in retrosternal extended multinodular goitre: a comprehensive approach. Ind J Anesth Analg. 2024;11(2):103-8.
Licence:
Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
| Received | Accepted | Published |
|---|---|---|
| December 09, 2023 | February 01, 2024 | June 29, 2024 |
DOI: https://doi.org/10.21088/ijaa.2349.8471.11224.10
Keywords
Multinodular goitre (MNG)Fibreoptic extubationFibreoptic intubationThyroidSearch for Similar Articles
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Timeline
| Received | December 09, 2023 |
| Accepted | February 01, 2024 |
| Published | June 29, 2024 |
licence
Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)
This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
