Journal of Southern Medical University ›› 2005, Vol. 25 ›› Issue (08): 1051-1053.

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Management of thyroid disease-induced tracheostenosis

TANG You-qing1, GUO Zhen-hui1, ZHOU Juan2, YE Yao-qin3, ZOU Xia-ying2, DENG Qing-nan1   

  1. 1. 广州军区广州总医院急危重症救治中心ICU, 广东, 广州, 510010;
    2. 广州军区广州总医院老年呼吸内科, 广东, 广州, 510010;
    3. 第二军医大学长征医院呼吸内科, 上海, 200003
  • Online:2005-08-20 Published:2005-08-20

Abstract: 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 brochosconpy 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.

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