Effective Management of a Total Thyroidectomy Case with Positive Cuff Leak Test: A Case Report
Abstract:
Total thyroidectomy is frequently performed
to treat various thyroid conditions, such as malignancies, large goiters, and
Graves' disease. One of the possible complications after this surgery is airway
obstruction, which can be evaluated intraoperatively using the cuff leak test
(CLT). A positive CLT suggests significant airway edema or obstruction, which
can lead to postoperative respiratory difficulties. Managing a patient with a
positive CLT after thyroidectomy necessitates a multidisciplinary approach,
including close monitoring, prompt intervention, and appropriate postoperative
care. This case shows the management of a patient who developed a positive cuff
leak test following a total thyroidectomy. Key strategies involved
administering corticosteroids to mitigate airway edema, ensuring close
observation in an intensive care unit (ICU), and considering reintubation or
tracheostomy if airway obstruction persisted. The patient was successfully
managed through conservative measures, avoiding the need for invasive airway
procedures. This case underscores the importance of vigilance and timely
intervention in the postoperative period to secure patient safety and achieve
favorable outcomes after total thyroidectomy. The discussion highlights the
necessity of tailoring care plans to the severity of the airway compromise and
the overall clinical condition of the patient. This case adds to the
understanding of airway management in thyroidectomy patients and the utility of
CLT in guiding clinical decisions.
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