Journal article
Airway Management in Substernal Goiter Surgery
Annals of otology, rhinology & laryngology, Vol.131(2), pp.225-228
02/01/2022
DOI: 10.1177/00034894211014794
PMID: 34032125
Abstract
Objective(s): To review the experience of 3 hospitals with airway management during surgery for substernal goiter and identify preoperative factors that predict the need for advanced airway management techniques. Methods: A retrospective chart review between 2009 and 2017 of patients with substernal goiter treated surgically at 1 of 3 hospitals was performed. Results: Of the 179 patients included in the study, 114 (63.7%) were female, the mean age was 55.1 years (range 20-87). Direct laryngoscopy or videolaryngoscopy was successful in 162 patients (90.5%), with fiberoptic intubation used for the remaining 17 patients. Thirty-one patients (17.4%) required >1 intubation attempt; these patients had larger thyroids (201.3 g, 95% CI 155.3-247.2 g) than those intubated with 1 attempt (144.7 g, 95% CI 127.4-161.9 g, P = .009). Those who required >1 attempt had higher BMI (38.3, 95% CI 34.0-42.6 vs. 32.9, 95% CI 31.5-34.3, P = .02). Mallampati score was found to be a predictor of >1 attempt, though tracheal compression and tracheal shift were not found to be predictors of >1 attempt, nor was the lowest thyroid extent. BMI was the only independent factor on multivariable logistic regression of needing >1 attempt (odds ratio 1.056, 95% CI 1.011-1.103, P = .015). Conclusions: The majority of patients undergoing surgery for substernal goiter can be intubated routinely without the need for fiberoptic intubation. Thyroid-specific factors such as lowest thyroid extent and mass effect of the gland on the trachea do not appear to be associated with difficult intubation, whereas classic patient factors associated with difficulty intubation are.
Details
- Title: Subtitle
- Airway Management in Substernal Goiter Surgery
- Creators
- Kendall K. Tasche - University of Iowa Hospitals and ClinicsAshley M. Dorneden - University of New MexicoWilliam M. Swift - University of Virginia Health SystemNathan H. Boyd - University of New MexicoDavid C. Shonka - University of Virginia Health SystemNitin A. Pagedar - University of Iowa Hospitals and Clinics
- Resource Type
- Journal article
- Publication Details
- Annals of otology, rhinology & laryngology, Vol.131(2), pp.225-228
- Publisher
- Sage
- DOI
- 10.1177/00034894211014794
- PMID
- 34032125
- ISSN
- 0003-4894
- eISSN
- 1943-572X
- Number of pages
- 4
- Grant note
- UL1TR002537 / National Institutes of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA P30CA086862 / National Institutes of Health/National Cancer Institute; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Cancer Institute (NCI)
- Language
- English
- Date published
- 02/01/2022
- Academic Unit
- Otolaryngology
- Record Identifier
- 9984312247902771
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