Delayed Multifocal Tracheal Injury Following Thyroidectomy: A Case Report and Review of the Literature.

Delayed presentation of tracheal injury after thyroidectomy is a rare complication. We present the case of a 24-year-old male presenting with findings of tracheal injury 12 days after total thyroidectomy. Upon surgical exploration, multifocal, transmural tracheal injuries were identified. Repair was performed with a combination of acellular dermal matrix allograft, local-regional flaps, silicone stenting, and tracheostomy. Herein we also review published cases of delayed tracheal injury. Our findings suggest that delayed tracheal necrosis and rupture is an uncommon yet potentially devastating complication of thyroidectomy. Surgeons should maintain a low threshold to suspect such injuries when patients present with neck swelling and subcutaneous emphysema, even up to 40 days post-operatively. Complex injuries may require a multidisciplinary approach and an armamentarium of reconstructive techniques.