title: Hibernoma larynx with large multinodular goitre: unusual airway challenge.
abstract: A 56-year-old man presented with a 6-month history of progressively increasing neck swelling, dysphagia and hoarseness of voice. CT scan revealed multi-nodular goitre and also showed a lesion in the supraglottis. It also showed another lesion in the supraglottis. Fine-needle aspiration cytology of thyroid revealed follicular cells. Routine flexible laryngoscopy was performed to evaluate vocal cord function; however, we found a smooth well-defined lesion just above the glottis, obstructing the direct view of the vocal cords, and an endangered airway. A provisional diagnosis of a laryngeal cyst was made. With all necessary precautions intubation was performed with a bougie and a reinforced endotracheal tube was inserted. Total thyroidectomy was performed first. With direct suspension laryngoscopy an attempt was made to deliver the laryngeal lesion, however, the lesion could not be removed. A suprahyoid lateral pharyngotomy was performed to deliver the lesion. Histopathology of the lesion revealed hibernoma.
authors.affiliation: Section of Otolaryngology, Department of Surgery, Aga Khan University Hospital, Karachi, Sindh, Pakistan.
authors.forename: Haissan
authors.initials: H
authors.lastname: Iftikhar
authors.affiliation: Section of Otolaryngology, Department of Surgery, Aga Khan University Hospital, Karachi, Sindh, Pakistan.
authors.forename: Moghira Iqbaluddin
authors.initials: MI
authors.lastname: Siddiqui
mesh_terms: D000402:Airway Obstruction / Q000209:etiology; D003560:Cysts / Q000175:diagnosis; D003937:Diagnosis, Differential; D006042:Goiter / Q000150:complications*; D006801:Humans; D007818:Laryngeal Diseases / Q000175:diagnosis; D007822:Laryngeal Neoplasms / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D007828:Laryngoscopy; D008067:Lipoma / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010614:Pharynx / Q000601:surgery; D013965:Thyroidectomy