Anaesthetic Management for Massive Neck Mass with Retrosternal Extension with Severe Tracheal Narrowing posted for Thyroidectomy: A Case Report

Abstract

Anesthetic management in patients with large mediastinal mass is challenging owing to the cardiorespiratory compromise that can happen following induction of anaesthesia. We describe a 52 years old lady with a large anterior neck mass (thyroid malignancy?) for thyroidectomy with severe tracheal narrowing with risk of cardiorespiratory compromise owing to the mediastinal mass syndrome. Awake fibreoptic intubation was planned. After meticulous dissection and surgery the mass was removed without any cardiorespiratory compromise intraoperatively. A tracheostomy was done owing to the soft trachea. Close communication between the surgeons and the anesthesiologist helped in the successful outcome of the patient.