M J Belmont1, M K Wax, F N DeSouza. 1. Department of Otolaryngology-HNS, State University of New York at Buffalo, Buffalo General Hospital, 14203, USA.
Abstract
BACKGROUND: 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. METHODS: A case report of a patient with a neglected thyroid lymphoma is presented. RESULTS: 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. CONCLUSIONS: 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.
BACKGROUND: 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. METHODS: A case report of a patient with a neglected thyroid lymphoma is presented. RESULTS: 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. CONCLUSIONS: 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.
Authors: J Adam Law; Natasha Broemling; Richard M Cooper; Pierre Drolet; Laura V Duggan; Donald E Griesdale; Orlando R Hung; Philip M Jones; George Kovacs; Simon Massey; Ian R Morris; Timothy Mullen; Michael F Murphy; Roanne Preston; Viren N Naik; Jeanette Scott; Shean Stacey; Timothy P Turkstra; David T Wong Journal: Can J Anaesth Date: 2013-10-17 Impact factor: 5.063