PDF(Pubmed)
Abstract：
BACKGROUND: Nontoxic nodular goiter is one of the most prevalent thyroid conditions worldwide. Thyroidectomy for large goiters has a relatively high risk of postoperative airway obstruction, with tracheomalacia being one of the potential complications.
METHODS: A 61-year-old woman complained of a lump in her neck for 45 years. The node is progressively enlarged, but she did not experience any breathing difficulty, hoarseness, or pain while swallowing. A total thyroidectomy was then performed. The histopathologic examination revealed colloid goiter. During the procedure, evaluation of the trachea revealed a tracheomalacia, so a tracheotomy was then performed on the patient. After a follow-up period of three months, the patient was no longer experiencing tracheomalacia, and the tracheostomy was successfully closed.
CONCLUSIONS: Surgery has been considered an acceptable approach for managing non-toxic goiter. The most common indications are compressive symptoms, substernal extension, inability to control hyperthyroidism through medication, and a suspicion of malignancy. However, thyroidectomy for large goiter carries a relatively high risk of postoperative respiratory obstruction. Diagnosing tracheomalacia can be challenging and often relies on bronchoscopy to assess the airway and observe the collapse of cartilage and membranes. Acquired tracheomalacia can be managed through internal or external stenting or tracheostomy.
CONCLUSIONS: Total thyroidectomy has been recommended as a suitable procedure for non-toxic and toxic multinodular goiter. Tracheomalacia may occur following thyroidectomy in patients with thyroid enlargement. Tracheostomy effectively manages tracheomalacia by creating a channel across the malacia\'s focal segment, restoring the airway\'s patency.
METHODS: A 61-year-old woman complained of a lump in her neck for 45 years. The node is progressively enlarged, but she did not experience any breathing difficulty, hoarseness, or pain while swallowing. A total thyroidectomy was then performed. The histopathologic examination revealed colloid goiter. During the procedure, evaluation of the trachea revealed a tracheomalacia, so a tracheotomy was then performed on the patient. After a follow-up period of three months, the patient was no longer experiencing tracheomalacia, and the tracheostomy was successfully closed.
CONCLUSIONS: Surgery has been considered an acceptable approach for managing non-toxic goiter. The most common indications are compressive symptoms, substernal extension, inability to control hyperthyroidism through medication, and a suspicion of malignancy. However, thyroidectomy for large goiter carries a relatively high risk of postoperative respiratory obstruction. Diagnosing tracheomalacia can be challenging and often relies on bronchoscopy to assess the airway and observe the collapse of cartilage and membranes. Acquired tracheomalacia can be managed through internal or external stenting or tracheostomy.
CONCLUSIONS: Total thyroidectomy has been recommended as a suitable procedure for non-toxic and toxic multinodular goiter. Tracheomalacia may occur following thyroidectomy in patients with thyroid enlargement. Tracheostomy effectively manages tracheomalacia by creating a channel across the malacia\'s focal segment, restoring the airway\'s patency.
摘要：
背景：无毒结节性甲状腺肿是全球最常见的甲状腺疾病之一。甲状腺切除术治疗大型甲状腺肿术后气道阻塞的风险相对较高,气管软化是潜在的并发症之一。
方法：一名61岁女性主诉颈部肿块45年。节点逐渐扩大，但她没有呼吸困难,声音嘶哑,或吞咽时疼痛。然后进行全甲状腺切除术。组织病理学检查显示胶体甲状腺肿。在手术过程中,气管评估显示气管软化，然后对病人进行了气管切开术。经过三个月的随访，病人不再有气管软化症,气管造口术成功关闭.
结论：手术被认为是治疗非毒性甲状腺肿的一种可接受的方法。最常见的适应症是压迫症状，胸骨下延伸，无法通过药物控制甲状腺功能亢进，还有恶性肿瘤的嫌疑.然而,甲状腺切除术治疗大型甲状腺肿，术后呼吸道阻塞的风险相对较高。诊断气管软化可能具有挑战性，通常依靠支气管镜检查来评估气道并观察软骨和膜的塌陷。可以通过内部或外部支架或气管造口术来管理获得的气管软化。
结论：甲状腺全切除术已被推荐为无毒和毒性多结节性甲状腺肿的合适手术。甲状腺切除术后甲状腺肿大患者可能会发生气管软化。气管造口术通过在软化区的病灶段创建通道，有效地管理气管软化，恢复气道的通畅。
方法：一名61岁女性主诉颈部肿块45年。节点逐渐扩大，但她没有呼吸困难,声音嘶哑,或吞咽时疼痛。然后进行全甲状腺切除术。组织病理学检查显示胶体甲状腺肿。在手术过程中,气管评估显示气管软化，然后对病人进行了气管切开术。经过三个月的随访，病人不再有气管软化症,气管造口术成功关闭.
结论：手术被认为是治疗非毒性甲状腺肿的一种可接受的方法。最常见的适应症是压迫症状，胸骨下延伸，无法通过药物控制甲状腺功能亢进，还有恶性肿瘤的嫌疑.然而,甲状腺切除术治疗大型甲状腺肿，术后呼吸道阻塞的风险相对较高。诊断气管软化可能具有挑战性，通常依靠支气管镜检查来评估气道并观察软骨和膜的塌陷。可以通过内部或外部支架或气管造口术来管理获得的气管软化。
结论：甲状腺全切除术已被推荐为无毒和毒性多结节性甲状腺肿的合适手术。甲状腺切除术后甲状腺肿大患者可能会发生气管软化。气管造口术通过在软化区的病灶段创建通道，有效地管理气管软化，恢复气道的通畅。
