Delayed Tracheal Perforation after Hemithyroidectomy

Melina Benson, Vaninder Dhillon and Ralph Tufano

Department of Otolaryngology and Head and Neck Surgery, The Johns Hopkins University, Maryland, USA

^*Correspondance to: Ralph Tufano 

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Abstract:

Background: Hemithyroidectomy is a low-risk, outpatient procedure commonly performed for benign and some small, differentiated thyroid malignancies. Delayed tracheal perforation is exceedingly rare and has previously only been reported after total thyroidectomy.Case Report: We describe a 25-year-old patient who underwent an unremarkable right hemithyroidectomy to remove a 4 centimeter FNAB cytologically indeterminate thyroid nodule, who presented four weeks later with acute anterior neck swelling and subcutaneous emphysema after strenuous exercise. Computed tomography showed pockets of air tracking along a right lateral tracheal wall irregularity on the operative side. Flexible tracheobronchoscopy identified a pinholesized defect. A bedside neck evacuation of the air was performed with drain placement. The patient was restricted to limited activity for 4 weeks.Results: The patient recovered uneventfully.Conclusion: Surgeons who perform thyroid surgery must be aware of the possibility of delayed tracheal perforation after hemithyroidectomy. Conservative management may be appropriate for the stable patient.

Keywords:

Endocrine; Thyroid cancer; Hemithyroidectomy; Late complication; Tracheal injury

Cite the Article:

Benson M, Dhillon V, Tufano R. Delayed Tracheal Perforation after Hemithyroidectomy. Ann Clin Case Rep. 2017; 2: 1355.