title: Benign nodular goitre presenting as acute airway obstruction.
abstract: BACKGROUND
  Although rare in non-endemic areas, benign nodular goitre may cause acute airway obstruction and the clinical management of this condition remains a challenge.
  
  
  METHODS
  From 1996 to 2005, a total of 1115 patients underwent thyroid surgery at our institution and of these, 7 patients were identified to have a benign nodular goitre leading to acute airway obstruction. They were retrospectively reviewed with reference to the aetiology, presentation, perioperative management and postoperative outcome.
  
  
  RESULTS
  All seven patients were elderly women with a history of symptomatic goitre and concomitant medical problems. Five patients required emergency tracheal intubation, whereas two patients underwent urgent tracheostomy. Total thyroidectomy was successfully carried out for all patients and there was no hospital death. Perioperative complications included three patients with pneumonia, two with renal failure and one with perforated duodenal ulcer. Surgically related complications included transient recurrent nerve palsy in one patient and transient hypocalcaemia in four. After a median follow up of 22 months (range, 4-53 months), two patients died of cerebrovascular accident.
  
  
  CONCLUSIONS
  Prompt airway protection followed by total thyroidectomy within the same hospital admission should be recommended and can be associated with favourable outcome.
authors.affiliation: Department of Surgery, The University of Hong Kong Medical Centre, Queen Mary Hospital, Pokfulam, Hong Kong, China.
authors.forename: Deepak
authors.initials: D
authors.lastname: Abraham
authors.forename: Nikhil
authors.initials: N
authors.lastname: Singh
authors.forename: Brian
authors.initials: B
authors.lastname: Lang
authors.forename: Wai-Fan
authors.initials: WF
authors.lastname: Chan
authors.forename: Chung-Yau
authors.initials: CY
authors.lastname: Lo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000402:Airway Obstruction / Q000209:etiology* / Q000601:surgery; D005260:Female; D006044:Goiter, Nodular / Q000150:complications* / Q000601:surgery; D006801:Humans; D007442:Intubation, Intratracheal; D012189:Retrospective Studies; D013965:Thyroidectomy; D014139:Tracheostomy