Serial fiber optic bronchoscopy (FOB) to predict the need of tracheostomy in tracheomalacia after thyroidectomy in long standing goiter

Tracheomalacia, a rare complication after thyroidectomy, presents with post-operative stridor immediately after extubation of trachea. Tracheomalacia is defined as dynamic airway collapse in excess of 50% of diameter due to inability of cartilaginous framework to maintain airway patency [1,2]. Tracheostomy is the most common and definitive modality of treatment [3]. Diagnosis of tracheomalacia and decision to go for tracheostomy is a difficult task as spontaneous improvement occurs with time. Cuff leak tests during positive pressure ventilation and spontaneous respiration are described and done routinely to predict or rule out causes of post-extubation stridor (e.g, laryngeal edema, recurrent laryngeal nerve palsy, tracheomalacia), but the sensitivity and specificity are low [5] and cannot pin point the exact diagnosis.
Source: Journal of Clinical Anesthesia - Category: Anesthesiology Authors: Tags: Correspondence Source Type: research