Radiological assessment of difficult airway in thyroid malignancy – a retrospective case study

Author: 
Vedula Padmini Saha, Animesh Ghosh, Shivaam Kesarwaani, Nandhini. M.K and Somnath Saha,

Aims & Objective: To propose the importance of doing a radiological assessment for any thyroid malignancy before opting for intervention, in-order to assess the severity of the disease and also to proceed with further better management.
Materials & Methods: Study includes a total number of 4 cases of advanced thyroid malignancy, who presented to emergency department of ENT & Head - Neck Surgery, Calcutta National Medical College from March 2018 to April 2019. Patients were stabilized in emergency department & underwent ENT & systemic examinations. All cases were subjected to radiological investigations like plain radiography and Contrast enhanced CT scan of neck to better understand & study the disease extention. The parameters assessed were:
1. The extent of the disease.
2. Tracheal involvement.
3. Tracheal compression.
4. Other viscera involved.
5. Pretracheal space involvement.
Result: Tracheal compression was noted in 100% cases and tracheal involvement in 50% of total cases. Tracheal narrowing of about 70% was noticed in all cases, although the voice of the patient was absolutely normal in all the cases. Vascular involvement was seen in 75% cases and in the form of 360 degree was seen in 25%. Retrosternal extension was noted in 100% cases and pretracheal space involvement in 75% cases.
Conclusion: Thyroid malignancy especially anaplastic carcinoma can be very aggressive, where CT assessment is of utmost importance in view of management. It helps in assessing the risk for any intervention. It gives a cue if patient can be salvaged.

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DOI: 
http://dx.doi.org/10.24327/ijcar.2019.18752.3592
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