title: Management of the compromised airway and role of tracheotomy in anaplastic thyroid carcinoma.
abstract: BACKGROUND
  Anaplastic thyroid carcinoma (ATC) is an uncommon thyroid malignancy with a poor prognosis. American Thyroid Association (ATA) guidelines acknowledge the complexity of airway management in these patients. We studied our local experience with the aim of providing guidance in airway management in ATC.
  
  
  METHODS
  Patients with histologically confirmed ATC from January 2004 to December 2011 were identified from our institutional database. The data were retrospectively analyzed using hospital case notes.
  
  
  RESULTS
  Twenty-six patients were identified with ATC, 25 of who died from the disease. Five of 26 patients (19%) had stridor at presentation. A further 6 of 26 patients (23%) developed stridor during or soon after radiotherapy. Nine patients (36%) died of airway obstruction.
  
  
  CONCLUSIONS
  Tracheotomy can facilitate completion of palliative treatment in those patients with ATC and stridor. Given the short life expectancy of these patients, a balanced decision must be made regarding the role and timing of tracheotomy.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, The Christie Hospital, Manchester, United Kingdom.
authors.forename: Navin
authors.initials: N
authors.lastname: Mani
authors.affiliation: Department of Otolaryngology, University Hospital of South Manchester, Manchester, United Kingdom.
authors.forename: Katherine
authors.initials: K
authors.lastname: McNamara
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, The Christie Hospital, Manchester, United Kingdom.
authors.forename: Natalie
authors.initials: N
authors.lastname: Lowe
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Central Manchester University Hospitals, Manchester, United Kingdom.
authors.forename: Sean
authors.initials: S
authors.lastname: Loughran
authors.affiliation: Department of Clinical Oncology, The Christie Hospital, Manchester, United Kingdom.
authors.forename: Beng K
authors.initials: BK
authors.lastname: Yap
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000402:Airway Obstruction / Q000209:etiology / Q000601:surgery*; D017024:Chemotherapy, Adjuvant / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D012189:Retrospective Studies; D065646:Thyroid Carcinoma, Anaplastic / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D013964:Thyroid Neoplasms / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D014140:Tracheotomy / Q000379:methods
keywords: airway obstruction; anaplastic thyroid cancer; stridor; tracheotomy