Dynamic ultrasound assessment of airway: A novel approach in a patient with goitre

Abstract

A 31-year-old female with bilateral neck swelling causing tracheal narrowing and deviation of trachea to the left side was posted for total thyroidectomy. Long standing thyroid swellings with or without associated airway compromise are a challenge for anaesthesiologists to secure the airway. Because of the thyroid swelling, there may be deviation of trachea and/or compression of the trachea. Here we present a case of long-standing goitre with tracheal deviation and compression of trachea at the level of 2nd tracheal ring. Securing the airway in such cases poses a great challenge requiring meticulous planning and skillful experience. Careful preoperative evaluation and preparation in the form of clinical and radiological assessment is essential in formulating a plan of anaesthesia. Though static assessment is always important and helps in deciding the plan of management, conventional parameters may not be true in all cases such as in ours. Dynamic assessment may help the anaesthesiologist in deciding airway management in such cases.