Thyroid Surgery

Useful Risk Reduction and Management Strategies
Acute respiratory distress following thyroidectomy can be of several types:
• Postoperative hemorrhage and hematoma – usually within 24 h, often 6–8 h after
thyroidectomy, causing laryngeal edema, which if uncorrected may prove fatal
• Excessive wound edema – causing pressure on the larynx and surrounding tissues
• Post-traumatic from endotracheal intubation
• Idiopathic – no apparent cause
Management
• Treat major bleeding with urgent surgical drainage.
• Ice packs on the neck after thyroidectomy – routine use may reduce wound
edema.
• Humidifi ed respiratory environment can relieve all local forms of laryngeal
edema.
• Check for inspissated subglottic mucus sputum retention (plug) – endotracheal
suction.
• Tracheostomy is rarely required.