Successful airway management in a comorbid patient with retrosternal goiter: A case study on lipoma excision and biopsy

Abstract

This case study presents the management of a 54-year-old British male patient suffering from rerosternal goiter with a BMI of 46.11, who was scheduled for lipoma excision and biopsy with adjacent tissue transfer or rearrangement on the back. The patient had a complex medical history, including type 2 diabetes mellitus, hypertension, hyperlipidemia, and obstructive sleep apnea. Preoperative assessments revealed difficulties in mask ventilation, intubation, and ventilation due to anatomical factors, such as a thyromental distance of less than 6 cm and a large retrosternal goiter causing compressive symptoms and wheezy breathing. A multidisciplinary team implemented a dual-plan approach utilizing a laryngeal mask airway (LMA) as the primary airway management strategy, with an endotracheal tube as the backup plan. The patient underwent successful surgery with stable vital signs and optimal oxygenation. This case emphasizes the significance of comprehensive preoperative assessments, multidisciplinary collaboration, and adaptable airway management strategies in challenging surgical cases.