Awake Fiberoptic Nasotracheal Intubation and Anesthetic Management of a Patient With a Compressed and Deviated Airway From a Massive Thyroid Goiter: A Case Report

Difficult airway management is a challenge for anesthesiologists, requiring proper assessment, planning, and sometimes a multidisciplinary approach to establish a secure airway. Here we present a case where the patient had a large thyroid goiter with significant tracheal compression. Due to the larg...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2023-02, Vol.15 (2), p.e35278
Main Authors: Tan, Didem, Zhang, Xuechao
Format: Article
Language:English
Subjects:
Airway management
Algorithms
Anesthesiology
Bronchoscopy
Case reports
Edema
Extracorporeal membrane oxygenation
Extubation
General anesthesia
Goiter
Intensive care
Intubation
Larynx
Medical imaging
Medical personnel
Ostomy
Otolaryngology
Respiration
Sleep apnea
Thyroid gland
Thyroidectomy
Tracheotomy
Ventilators
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Summary:Difficult airway management is a challenge for anesthesiologists, requiring proper assessment, planning, and sometimes a multidisciplinary approach to establish a secure airway. Here we present a case where the patient had a large thyroid goiter with significant tracheal compression. Due to the large size of the thyroid mass and the location of tracheal narrowing, fiberoptic intubation appeared to be challenging, and a surgical airway was not a viable option to obtain a secure airway for a total thyroidectomy. This case report discusses awake fiberoptic intubation and intraoperative anesthetic management of a patient with known airway compression and explores the alternative method for obtaining a definitive airway through venovenous extracorporeal membrane oxygenation.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.35278