Threading a Needle: Difficult Airway Management in a Patient With Obstructive Goiter

Document Type

Conference Proceeding

Publication Date



Large goiters can lead to a compressed and distorted airway, making endotracheal intubation a challenge. We report the airway management of a 66-year-old male undergoing total thyroidectomy for an enlarged substernal multinodular goiter measuring 6.4cm anteroposterior by 8.9cm transversally that significantly compressed the trachea. The chosen intubation technique was awake fiberoptic intubation requiring topical local anesthetic which proved to be successful. We will discuss indications for performing fiberoptic intubation, the techniques involved, and the possible challenges that might arise.


American Society of Anesthesiologists Annual Meeting, October 12-16, 2023, San Francisco, CA