caa a22 4500 445374306 CHVBK 20180317142958.0 cr unu---uuuuu 170323e20111001xx s 000 0 eng 10.1007/s00540-011-1181-9 doi (NATIONALLICENCE)springer-10.1007/s00540-011-1181-9 Tracheomalacia after reoperation for an adenomatous goiter located in a unique position [Elektronische Daten] [Yosuke Nakadate, Taeko Fukuda, Hisato Hara, Makoto Tanaka] Tracheomalacia after thyroidectomy is a life-threatening situation. However, it is difficult to predict postoperative tracheal obstruction with certainty. A case of a 74-year-old woman with a long-standing adenomatous goiter (98g) is reported. She had undergone partial right lobe thyroidectomy 54years earlier. After total thyroidectomy, she was reintubated and required a tracheostomy because of tracheomalacia. The right residual thyroid tumor weighed only 5g, but it extended to the retrotracheal space. Because the right lobe had stretched the membranous wall of the trachea over a long period of time, the tracheal lumen was thought to have collapsed because of loss of the foundation of the tracheal cartilage (the residual right lobe) along with the supportive surrounding tissue (the left lobe) after surgery. The present case suggests that the occurrence of tracheomalacia could be attributed to reoperation and retrotracheal extension. Thus far, six preoperative predictive factors for the development of severe postoperative respiratory obstruction have been reported: goiter for more than 5years, preoperative recurrent laryngeal nerve palsy, significant tracheal narrowing and/or deviation, retrosternal extension, difficult endotracheal intubation, and thyroid cancer. Two more factors, reoperation and retrotracheal extension of tumor, may also be risks for airway obstruction after thyroidectomy. Japanese Society of Anesthesiologists, 2011 Adenomatous goiter nationallicence Membranous wall of the trachea nationallicence Postoperative airway obstruction nationallicence Nakadate Yosuke Department of Anesthesiology, Faculty of Medicine, University of Yamanashi, 1110 Shimogato, 409-3898, Chuo, Yamanashi, Japan aut Fukuda Taeko Department of Anesthesiology, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences, Tsukuba University, 1-1-1 Tennodai, 305-8575, Tsukuba City, Ibaraki, Japan aut Hara Hisato Department of Breast Thyroid Endocrine Surgery, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences, Tsukuba University, 1-1-1 Tennodai, 305-8575, Tsukuba City, Ibaraki, Japan aut Tanaka Makoto Department of Anesthesiology, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences, Tsukuba University, 1-1-1 Tennodai, 305-8575, Tsukuba City, Ibaraki, Japan aut Journal of Anesthesia Springer Japan 25/5(2011-10-01), 745-748 0913-8668 25:5<745 2011 25 540 https://doi.org/10.1007/s00540-011-1181-9 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00540-011-1181-9 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Nakadate Yosuke Department of Anesthesiology, Faculty of Medicine, University of Yamanashi, 1110 Shimogato, 409-3898, Chuo, Yamanashi, Japan aut NATIONALLICENCE 700 1- Fukuda Taeko Department of Anesthesiology, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences, Tsukuba University, 1-1-1 Tennodai, 305-8575, Tsukuba City, Ibaraki, Japan aut NATIONALLICENCE 700 1- Hara Hisato Department of Breast Thyroid Endocrine Surgery, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences, Tsukuba University, 1-1-1 Tennodai, 305-8575, Tsukuba City, Ibaraki, Japan aut NATIONALLICENCE 700 1- Tanaka Makoto Department of Anesthesiology, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences, Tsukuba University, 1-1-1 Tennodai, 305-8575, Tsukuba City, Ibaraki, Japan aut NATIONALLICENCE 773 0- Journal of Anesthesia Springer Japan 25/5(2011-10-01), 745-748 0913-8668 25:5<745 2011 25 540 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer