Airway management for symptomatic benign thyroid goiters with retropharyngeal involvement: Need for a surgical airway with report of 2 cases

Background: Intubation prior to surgical intervention for thyroid goiters is typically straightforward and uneventful. However, retropharyngeal extension of thyroid goiters is a unique entity which is characterized by displacement of the hypopharynx and laryngeal deviation. Methods: Two patients presented with progressive compressive symptoms due to enlarging thyroid goiters. Imaging revealed thyroid goiters with significant retropharyngeal involvement causing anterior displacement of the larynx and hypopharynx. Results: Both patients were unsuccessfully intubated by direct laryngoscopy, GlideScope laryngoscopy and flexible fiberoptic laryngoscopy. Tracheostomy was performed to safely establish the airway, and thyroidectomy was subsequently performed uneventfully. Formalization of the tracheal stoma was performed on both patients to prevent soilage of the thyroid bed with tracheal secretions. Conclusions: Retropharyngeal involvement of thyroid goiters can pose significant difficulty with intubation. Airway compromise can be avoided by directly proceeding with a surgical airway. Management of the tracheal stoma is an important step in preventing postoperative infection

Septic arthritis of the sternoclavicular joint: A unique late complication after tracheostomy

BACKGROUND: Septic arthritis of the sternoclavicular joint is a rare infection associated with significant morbidity and mortality. Several risk factors for septic arthritis have been reported in the literature ranging from immunodeficiency to intravenous drug use. CASE PRESENTATION: A 63-year-old male previously treated for synchronous squamous cell carcinomas of the epiglottis and floor of mouth presented with tenderness and swelling of the sternoclavicular joint two months after tracheostomy decannulation. Computed tomography and bone scans confirmed the diagnosis of septic arthritis of the sternoclavicular joint. The patient\u27s clinical course, surgical treatment, and management considerations are discussed here. CONCLUSION: Septic arthritis of the SCJ is a rare but serious infection. Once diagnosed, septic arthritis of the SCJ should be promptly treated to prevent further morbidity and mortality

Landscape of innate lymphoid cells in human head and neck cancer reveals divergent NK cell states in the tumor microenvironment

10.1073/pnas.2101169118Proceedings of the National Academy of Sciences of the United States of America11828e210116911