Elective short-term nasotracheal intubation for postthyroidectomy tracheomalacia due to a long-standing large goiter: An experience at tertiary care center

Long-standing large goiters impose possibility of various complications. Tracheomalacia is one such feared problem. The presence of bilateral mobile vocal folds and extubation failure after surgery affirms diagnosis. Methods to deal with tracheomalacia include silicon tracheal stent grafts, tracheostomy, and prolonged intubation. We share our experience of the successful management of tracheomalacia with elective short-term endotracheal intubation. A 36-year-old female presented with a massive neck swelling, for the past 9 years along with slight change in voice and breathing difficulty. We performed near total thyroidectomy for colloid goiter. Intra-operative assessment suggested tracheomalacia. We kept patient on nasotracheal intubation for 1 week, and then extubated successfully. Postthyroidectomy tracheomalacia is a rare but significant complication. We advocate trial of our successful method of elective short-term intubation for its management. This can prove an easy and cost-effective alternative in comparison with tracheostomy or tracheal stent grafts.