The Journal of Laryngology & Otology

Clinical Records

Extracorporeal oxygenation support for curative surgery in a patient with papillary thyroid carcinoma invading the trachea

H-K Jeona1, Y K Soa1, J-H Yanga2 and H-S Jeonga1 c1

a1 Department of Otorhinolaryngology – Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

a2 Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

Abstract

Objective: Local extension of thyroid carcinoma can result in massive invasion of the trachea, causing severe airway compromise. The pre- and peri-operative management of such airway compromise is difficult but critical. We report the use of extracorporeal oxygenation support as an alternative peri-operative airway management option in such a situation. This approach facilitated curative surgery in a patient with papillary thyroid carcinoma invading the trachea.

Method: We present a case report regarding extracorporeal oxygenation support in a patient with locally advanced thyroid carcinoma.

Results: The patient was a 68-year-old woman with aggressive thyroid papillary carcinoma invading the trachea. The airway was almost totally obstructed, and tracheal resection and end-to-end anastomosis was planned. A venovenous bypass catheter was placed for cardiopulmonary bypass, using the bilateral femoral veins. Curative surgery and reconstruction were then performed successfully, under general anaesthesia assisted by cardiopulmonary bypass oxygenation.

Conclusion: Cardiopulmonary bypass oxygenation is a safe and effective alternative airway management option in patients with locally aggressive thyroid cancer.

(Accepted May 27 2008)

(Online publication September 23 2008)

Correspondence:

c1 Address for correspondence: Dr Han-Sin Jeong, Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ir-Won Dong, Kang-Nam Gu, Seoul, 135-710, South Korea. Fax: 82 2 3410 6987 E-mail: hansin.jeong@samsung.com

Footnotes

Dr Han-Sin Jeong takes responsibility for the integrity of the content of the paper.

Competing interests: None declared