Emergency management of a patient with severe airway obstruction resulting from poorly differentiated thyroid carcinoma: A case report

Yang, Rong; Yu, Xiaofei; Ma, Liang; Wu, Fengbo

doi:10.3892/ol.2012.827

Cited by 8 publications

(4 citation statements)

References 11 publications

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“…In these situations, the visibility of the trachea becomes difficult, and thus, the tracheotomy is the best option to maintain an open airway. 23,25 In this case, at the time of admission, the patient had no common signs of severe vascular lesions, such as pulsatile bleeding, palpable thrill, or audible murmurs. Therefore, the emergency care team decided to perform a tracheotomy for the maintenance of a patent airway and await developments in the case before performing further treatment.…”

Section: Discussionmentioning

confidence: 94%

Life-Threatening Expansive Sublingual Hematoma

Ribeiro¹,

Silva²,

Menezes³

et al. 2014

Journal of Craniofacial Surgery

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Vascular injuries are a constant risk in facial trauma, although bone and soft tissues of the face have provided some protection to the larger blood vessels. However, penetrating injuries usually do not have this type of protection and can damage significant vascular arteries. This article presents a case of a stab wound, which led to airway obstruction arising to a large sublingual hematoma due to lingual artery injury. A healthy 44-year-old man was stabbed in the submandibular region and admitted with an airway obstruction. He was subjected to an emergency tracheotomy and evolved with progressive sublingual edema. Computed tomography (CT) angiography showed a left lingual artery injury with the formation of an expansive hematoma. The CT angiography findings helped to identify the cause of the hematoma and guided the surgery to drain the hematoma after ligation of the lingual artery. The treatment was safely performed as planned and evolved uneventfully. The patient recovered fast and well and presented normal functions 6 months after the treatment. This surgical technique is an effective method for treating such injuries because it can be safely performed when guided by CT angiography. The authors argue that the demand for vascular lesions should be routine in patients who have facial trauma.

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Section: Discussionmentioning

confidence: 94%

Life-Threatening Expansive Sublingual Hematoma

Ribeiro¹,

Silva²,

Menezes³

et al. 2014

Journal of Craniofacial Surgery

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“…However, if not possible, the stents can be removed from the airway [ 19 ]. Moreover, after inserting the stents, the patient is eligible to undergo definitive therapy for thyroid cancer, with improvement in symptoms and quality of life [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Bronchoscopy Laser and Silicone Y-Stents as Emergency Airway Management in Central Airway Stenosis Due to Secondary Thyroid Carcinoma: A Case Report

Elhidsi

Soehardiman

Wibawanto

et al. 2022

Case Reports in Pulmonology

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Total airway obstruction in thyroid cancer is rare and has high morbidity and mortality. Airway management in such cases is challenging, especially in cases in which thyroid masses cannot be totally resected. It is important to choose the appropriate airway treatment modality. Currently, therapeutic rigid bronchoscopy procedures and endoluminal lasers, as well as airway stent insertion, are a management modality of near-total malignant airway obstruction. We report a rigid bronchoscopy procedure combined with laser and Y-stent silicone insertion in thyroid cancer with extension infiltration, as well as compression in the trachea covering the subglottic tracheal area up to the main carina and tracheo-bronchomalacia, manifesting as acute respiratory failure.

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“…Poorly differentiated thyroid carcinoma is a group of carcinomas that exists between well differentiated and anaplastic thyroid carcinoma in terms of both morphological appearance and biological behavior [ 3 , 4 ]. The World Health Organization classification of endocrine tumors separately categorized poorly differentiated and well differentiated thyroid carcinoma in 2004.…”

Section: Discussionmentioning

confidence: 99%

A novel procedure for transtracheal resection for recurrent thyroid cancer involving a trachea and esophagus

et al. 2014

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BackgroundSurgery remains the main treatment for locally advanced thyroid cancers invading the trachea, esophagus, and recurrent laryngeal nerve. However, extensive resection of such tumors can sometimes involve difficulties and may result in the deterioration of the patient’s quality of life. The surgeon should consider not only the patient’s prognosis but also the preservation of postoperative function.MethodsThis report describes a minimally invasive surgical procedure for recurrent poorly differentiated papillary thyroid carcinoma involving the trachea and esophagus. To decrease the potential for recurrent laryngeal nerve injuries and to preserve both the tracheal and esophageal blood supply, we adapted a transtracheal approach; the recurrent tumor was safely and completely removed without causing a dysfunction. After a tracheotomy to the right, the tumor was easily detected through the tracheostoma and delineated by palpation. The mucous membrane of the trachea was minimally incised along the right-hand border of the tumor and a mucosal flap was elevated. The left side of the trachea including the membranous wall and cartilage of the tracheal mucosa was maximally preserved, to maintain the vascular supply to the trachea. Finally, the membranous wall of the trachea was preserved to within one-third of the left-hand side. Furthermore, the risk of bleeding from major lateral vessels was reduced. A sternocleidomastoid muscle flap was elevated and inserted into the cavity resulting from the tumor resection and sutured between the esophagus and trachea. The membranous wall of the tracheal mucosa was also sutured submucosally.ResultsThe tumor was removed completely with the muscular layer of the esophagus without injury to the intact recurrent laryngeal nerve and lateral major vessels. The patient started oral nutritional intake on the first postoperative day and was discharged without any significant postoperative complications.ConclusionsThis new procedure for transtracheal resection for recurrent thyroid cancer involving the trachea and esophagus was useful and safe.

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Emergency management of a patient with severe airway obstruction resulting from poorly differentiated thyroid carcinoma: A case report

Cited by 8 publications

References 11 publications

Life-Threatening Expansive Sublingual Hematoma

Life-Threatening Expansive Sublingual Hematoma

Bronchoscopy Laser and Silicone Y-Stents as Emergency Airway Management in Central Airway Stenosis Due to Secondary Thyroid Carcinoma: A Case Report

A novel procedure for transtracheal resection for recurrent thyroid cancer involving a trachea and esophagus

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