[Management of thyroid disease-induced tracheostenosis].
OBJECTIVE
To investigate the special clinical characteristics of thyroid disease-induced tracheostenosis and elaborate on its clinical management.


METHODS
A retrospective analysis of 10 cases of thyroid disease-induced tracheostenosis was performed by reviewing the clinical record of their misdiagnoses and diagnostic approaches with fiberoptic bronchoscopy and/or cervical CT, thyroid scanning and pathological examination. The management included resection of the thyroid gland and airway reconstruction.


RESULTS
Of the 10 patients, 3 were misdiagnosed to have bronchial asthma and 2 had a misdiagnosis of acute heart failure. Compression-induced tracheostenosis of grade II or III was identified by fiberoptic bronchoscopy or cervical CT, and the diagnosis of thyroid gland disease was established after pathological examination. Severe dyspnea was relieved in all patients after thyroid gland resection and airway reconstruction. Expandable metal stent placement was the most effective therapy for tracheostenosis induced by nodular goiter. Patients with tracheostomy cannula placement were at high risk of severe infection.


CONCLUSIONS
Thyroid disease-induced tracheostenosis is likely to be misdiagnosed, which is not difficult to prevent with constant awareness of the possibility. Severe dyspnea in these patients can be relieved effectively after thyroid gland resection and airway reconstruction, and the prognosis depends on the type of the thyroid disease, degree of the tracheostenosis and management approaches.
Tang
You-qing
YQ
Intensive Care Unit, Emergency and Critical Care Center, Guangzhou General Hospital of Guangzhou Command, Guangzhou 510010, China.
Guo
Zhen-hui
ZH
Zhou
Juan
J
Ye
Yao-qin
YQ
Zou
Xia-ying
XY
Deng
Qing-nan
QN
D000328:Adult; D000368:Aged; D001999:Bronchoscopy; D003951:Diagnostic Errors; D005260:Female; D006044:Goiter, Nodular / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014135:Tracheal Stenosis / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D014139:Tracheostomy