Delayed tracheal rupture following transoral endoscopic thyroidectomy vestibular approach: Case report and review of the literature

Background Although the transoral endoscopic thyroidectomy vestibular approach (TOETVA) has been proven to be a safe procedure for select patients, as it is a novel approach, all associated complications require adequate attention. Methods We presented a 49‐year old woman who underwent TOETVA develo...

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Bibliographic Details
Published in:Head & neck 2022-11, Vol.44 (11), p.E38-E44
Main Authors: Weng, Yu‐jing, Hu, Ben‐ling, Jiang, Jiang, Min, Lei, Ai, Qing, Chen, De‐biao, Chen, Wei‐chun, Huang, Zhi‐heng
Format: Article
Language:English
Subjects:
Case reports
complication
delayed tracheal rupture
energy device
Literature reviews
Rupture
Thermal injury
thyroid surgery
Thyroidectomy
transoral endoscopic thyroidectomy vestibular approach
Vestibular system
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Summary:Background Although the transoral endoscopic thyroidectomy vestibular approach (TOETVA) has been proven to be a safe procedure for select patients, as it is a novel approach, all associated complications require adequate attention. Methods We presented a 49‐year old woman who underwent TOETVA developed delayed tracheal rupture 1 week after surgery. An extensive search of literature was carried out using PubMed, Embase, and Web of Science for studies reporting tracheal injury following endoscopic thyroidectomy. Results Thirteen cases of endoscopic thyroidectomy were analyzed, including eight cases of TOETVA. Tracheal injury occurred during various procedures, including accidental dissection, surgical needle puncture, Hegar dilation and trocar placement, and thermal injury by the energy device. Conclusions Tracheal injury following TOETVA is an underreported complication that can be induced by various factors. Thermal injury to the trachea is more likely to cause a delayed rupture. Careful blunt dissection and standardized use of energy devices are suggested.
ISSN:1043-3074
1097-0347
DOI:10.1002/hed.27180