EAJAIC
Eurasian Journal of Anesthesiology and Intensive Care

The Eurasian Journal of Anesthesiology and Intensive Care (EAJAIC) is an independent-unbiased, peer-reviewed, "double-blind", and open-access journal of current national and international issues and reviews for original clinical and experimental research, interesting case reports, differential diagnoses, editorial opinions, letters to the editor, and educational papers in anesthesiology, algology, and intensive care medicine.

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Case Report
Challenges in airway management in patients undergoing thyroid surgeries – a case series
Abstract
Airway management in patients undergoing thyroid surgery poses unique challenges due to potential anatomical distortions caused by thyroid enlargement. Difficult intubation in such cases occurs in 2–12.7% of patients, with a failure rate of up to 0.5%. This case series highlights varied clinical scenarios of thyroid-related airway difficulties and underscores the importance of individualized anaesthetic strategies. We present four distinct cases of patients with large thyroid swellings, each illustrating different aspects of airway compromise and anesthetic management. A 56-year-old woman with a 20-year history of a massive goiter presented with severe airway deviation and narrowing. Awake fiberoptic intubation was successfully performed, followed by a total thyroidectomy. Postoperative tracheomalacia delayed extubation, which was eventually accomplished safely after 48 hours. A 40-year-old woman with bilateral thyroid enlargement and minimal compressive symptoms underwent conventional intubation following induction, with an uneventful perioperative course. A 55-year-old woman presented acutely with airway compromise due to long-standing multinodular goiter. A difficult airway was anticipated and managed with video laryngoscopy and bougie-assisted intubation. Tracheomalacia necessitated a delayed and carefully monitored extubation. A 64-year-old woman with a massive right thyroid lobe causing vascular compression and tracheal deviation was managed with nasal fiberoptic intubation. Surgery proceeded uneventfully, and extubation was successfully performed. This series highlights that the complexity of airway management in thyroid surgery varies significantly based on goiter size, anatomical distortion, and airway involvement. Awake fiberoptic intubation remains a cornerstone technique in managing difficult airways, especially in the presence of tracheal compression or deviation. Video-assisted devices and a multidisciplinary approach enhance safety and outcomes. An individualized, well-planned anesthetic approach based on thorough preoperative assessment is crucial in minimizing morbidity and ensuring safe airway management in thyroid surgery.

Keywords : Airway management, thyroid surgeries, fibreoptic intubation

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Article available in :
Volume 3, Issue 3, 2026
Page : 77-82
https://doi.org/10.51271/EAJAIC-0058
Article Information
Received : 29 Oca 2026
Accepted : 22 Nis 2026
Published : 29 Ağu 2026
Corresponding Author :

Archana Shivashankar: Department of Anaesthesiology, Ramaiah Medical College and Hospitals, Karnataka, India

[email protected]
Citation : Mateyadka MM, Turai A, Shivashankar A, Kaur N. Challenges in airway management in patients undergoing thyroid surgeries–a case series. Eur J Anesthesiol Intens Care. 2026;3(3):77-82. doi:10.51271/EAJAIC-0058

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