Airway Imaging, Flow Volume Loops, and Goiter Symptoms: Summary

Whitney Liddy, James L. Netterville, Selen Soylu, Gregory W. Randolph

Research output: Chapter in Book/Report/Conference proceedingChapter

1 Scopus citations

Abstract

Surgery for thyroid goiter presents a unique set of challenges to the surgeon based on goiter size and extent, associated distortion of complex neck base anatomy, and goiter vascularity. Specific goiter characteristics influence the risk of potential upper airway compromise as well as the intraoperative risk of injury to the parathyroid glands and recurrent laryngeal nerves. In this chapter, cervical and substernal goiter definition and clinical presentation are reviewed in addition to typical goiter workup and management options. Special consideration is given to airway assessment in the goiter patient, including a discussion of the potential for airway compromise and specific intubation concerns. Surgical technique for goiter resection is outlined with particular emphasis on strategies to reduce the risk of injury to important anatomic structures that may be distorted, such as the case of a retrotracheal or posterior mediastinal goiter and the associated ventral recurrent laryngeal nerve. In the special case of substernal goiter, specific circumstances that may necessitate the rare need for sternotomy are outlined. Finally, potential postoperative complications are discussed, including recurrent laryngeal nerve paralysis, hypoparathyroidism, and the more controversial rate of tracheomalacia.

Original languageEnglish (US)
Title of host publicationSurgery of the Thyroid and Parathyroid Glands
PublisherElsevier
Pages53-69
Number of pages17
ISBN (Electronic)9780323661270
ISBN (Print)9780323661287
DOIs
StatePublished - Jan 1 2021

Keywords

  • Cervical Goiter
  • Intubation
  • Parathyroid Gland
  • Recurrent Laryngeal Nerve
  • Sternotomy
  • Substernal Goiter
  • Tracheomalacia

ASJC Scopus subject areas

  • General Medicine

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