scholarly journals Effect of thyroidectomy in patients with tracheal compression

2021 ◽  
Vol 67 (11) ◽  
pp. 1649-1653
Author(s):  
Sinan Koycegiz ◽  
Vahit Mutlu ◽  
Fatma Atalay ◽  
Ayhan Kars ◽  
Kubra Topal ◽  
...  
Keyword(s):  
2013 ◽  
Vol 121 (03) ◽  
Author(s):  
M Pasieka ◽  
S Thavarajah ◽  
M Adamzik ◽  
A Paul ◽  
F Weber ◽  
...  

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Keon Young Park ◽  
Kevin C. Janek ◽  
Joshua L. Hermsen ◽  
Petros V. Anagnostopoulos ◽  
Hau D. Le

Abstract Introduction Congenital single lung (CSL) is a rare condition, and symptomatic patients often present with respiratory distress or recurrent respiratory infection due to mediastinal shift causing vascular or airway compression. Aberrant right subclavian artery (ARSA) is another rare congenital anomality that can lead to tracheal or esophageal compressions. There is only one other case of concurrent presentation of CSL and ARSA reported, which presented unique challenge in surgical management of our patient. Here we present a step-wise, multidisciplinary approach to manage symptomatic CSL and ARSA. Case presentation An infant girl with a prenatal diagnosis of CSL developed worsening stridor and several episodes of respiratory illnesses at 11 months old. Cross-sectional imaging and bronchoscopic evaluation showed moderate to severe distal tracheomalacia with anterior and posterior tracheal compression resulting from severe mediastinal rotation secondary to right-sided CSL. It was determined that her tracheal compression was mainly caused by her aortic arch wrapping around the trachea, with possible additional posterior compression of the esophagus by the ARSA. She first underwent intrathoracic tissue expander placement, which resulted in immediate improvement of tracheal compression. Two days later, she developed symptoms of dysphagia lusoria due to increased posterior compression of her esophagus by the ARSA. She underwent transposition of ARSA to the right common carotid with immediate resolution of dysphagia lusoria. As the patient grew, additional saline was added to the tissue expander due to recurrence in compressive symptoms. Conclusions Concurrent presentation of CSL and ARSA is extremely rare. Asymptomatic CSL and ARSA do not require surgical interventions. However, if symptomatic, it is crucial to involve a multidisciplinary team for surgical planning and to take a step-wise approach as we were able to recognize and address both tracheomalacia and dysphagia lusoria in our patient promptly.


2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P173-P174
Author(s):  
Mark T Agrama

Objectives Evaluate the effects of total thyroidectomy for euthyroid goiter causing tracheal compression on the apnea hypopnea index (AHI) in patients with obstructive sleep apnea (OSA). Demonstrate a relationship between tracheal compression and OSA. Methods A retrospective study of 8 patients with euthyroid goiter causing tracheal compression who had moderate or severe OSA. Between January 2004 and December 2007, 8 patients with these conditions were treated in a community hospital by the author. At least 1 compressive symptom (dysphagia, dyspnea, and/or orthopnea) was reported by all patients. Computed tomography of the neck and chest was used to confirm the extent of goiter and tracheal compression. OSA was confirmed with preoperative polysomnography. Total thyroidectomy was performed. Postoperative polysomnography was obtained after 90 days. Outcome measures were changes in compressive symptoms and AHI using paired t test. Results All 8 patients reported symptomatic control of compressive symptoms after thyroidectomy. 7 of 8 patients demonstrated postoperative improvement of AHI. The mean postoperative AHI decreased significantly from 52.1 to 36.6 (P < 0.05). Conclusions Total thyroidectomy for goiter causing tracheal compression can significantly improve symptoms and AHI in those patients who have OSA. Evaluation of patients with OSA should include screening for tracheal compression from goiter.


2018 ◽  
Vol 69 (4) ◽  
pp. 422-429
Author(s):  
Hedyeh Ziai ◽  
Nicole L. Lebo ◽  
Ania Z. Kielar ◽  
Michael J. Odell

Purpose To determine whether an ultrasonography (US)-defined thyroid volume can accurately predict substernal extension or tracheal narrowing. Methods After research ethics approval, we identified patients with thyroid nodules investigated with both US and computed tomography (CT). Reviewers assigned scores for both substernal extension and tracheal compression on CT using pre-established classification systems. Statistical analysis with receiver operating characteristic curve analysis was performed to find the US-determined thyroid volume thresholds that correlated with each substernal extension and tracheal compression. Results This study included 120 patients (mean age 63.4 years; SD ± 15.9; 67% female). Thirty-five patients (29%) had substernal extension. The mean US total thyroid gland volume in patients with and without substernal extension were 92.4 and 37.6 cm3, respectively ( P < .001). 86% of patients with substernal extension had tracheal narrowing vs. 27% of patients without substernal extension ( P < .0001). A cutoff dominant gland volume of ≥37.5 cm3 showed 83% sensitivity and 79% specificity for substernal extension (area under the curve [AUC] = 0.84). A total thyroid gland volume threshold of ≥37.8 cm3 showed 89% sensitivity and 87% specificity for any degree of tracheal narrowing (AUC = 0.90). Conclusions This study suggests that US volumes may be used as a predictor to identify those patients with thyroid enlargement who are most at risk of substernal extension and tracheal compression and who may benefit from preoperative CT imaging for optimal surgical and anesthetic planning.


2010 ◽  
Vol 71 (6) ◽  
pp. 408-415 ◽  
Author(s):  
Mehmet Ozgur Ozhan ◽  
Mehmet Anil Suzer ◽  
Nedim Cekmen ◽  
Ceyda Ozhan Caparlar ◽  
Mehmet Burak Eskin

2002 ◽  
Vol 30 (6) ◽  
pp. 804-806 ◽  
Author(s):  
H. Butterell ◽  
R. H. Riley

We present a case of negative pressure pulmonary oedema due to an overlooked cause. A 45-year-old female patient presented to the emergency department unconscious with severe pulmonary oedema. Subsequent investigations revealed a thyroid goitre causing significant tracheal compression. This case report highlights an extremely rare but potentially dangerous sequela of upper airway obstruction.


2020 ◽  
Author(s):  
Zie Ahmed Cheick Traore ◽  
N'guiessan Alphonse Aman ◽  
Zana Ismael Coulibaly ◽  
Kouadio Donatien Koffi ◽  
Ibrahiman Toure ◽  
...  

Abstract Background : Riedel's thyroiditis (RT) is a rare fibrosclerotic disease that affects the thyroid gland and surrounding tissues. The etiology is unknown, and it rarely affects the elderly.Case Presentation : A 56-year-old man, with no particular medical history, was seen in consultation at the Surgery Department of the Treichville Teaching University Hospital for a painless swelling of the anterior base of the neck. Physical examination showed a patient with inspiratory dyspnea probably due to tracheal compression. The patient underwent a subtotal thyroidectomy because of the clinical symptomatology and the persistence of dyspnea. Macroscopically, the thyroid mass was well-encapsulated, weighed 80g, and measured 10 cm x 5 cm x 2 cm. After section, we observed whitish fibrous nodules associated with pinkish-brownish band. Histologically, the architecture of thyroid tissue was restructured by dense and diffuse collagenous fibrosis in which rare atrophic thyroid vesicles were found. The fibrous areas were infiltrated by inflammatory elements, including lymphocytes, plasmocytes, and eosinophilic polynuclear cells. No malignant cells were found. Masson's trichrome staining confirmed the fibrous nature of the thyroid tissue, which is essential for the certain diagnosis of Riedel's thyroiditis. There was no postoperative complication Conclusion: Riedel's thyroiditis is a rare disease that is difficult to diagnose preoperatively despite advances in imaging and fine needle cytology screening methods. Histological examination of the sample confirms the diagnosis of Riedel's thyroiditis. Thyroidectomy is indicated in patients with compression symptoms. Clinicians should suspect Riedel's thyroiditis in patients with a hard thyroid mass with compressive symptoms, despite its rarity.


2006 ◽  
Vol 16 (5) ◽  
pp. 513-514
Author(s):  
Takayasu Nomura ◽  
Kazushi Yasuda ◽  
Norihisa Koyama

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