Gross tracheal deviation: airway challenges and concerns--two case reports.

Practical guidelines and algorithms may not always help in difficult airway management. Large thyroid swellings may be responsible for several difficulties during the perioperative period, such as distortion of the airway, endocrine disturbances and metabolic effects. We here discuss the airway management of two patients with huge thyroid enlargement and gross tracheal deviation. One of those patients had also retrosternal extension of goiter. Both patients were scheduled for an excision of their colloid goiter.