Anterior Mediastinaland Thyroid Mass in a Patient for Fracture Humerus Surgery: an Anesthetic's Challenge

Dr. Sarika Wadhwa, Dr. Snehlata Tavri, Dr. Tushar Vashist
2016 IOSR Journal of Dental and Medical Sciences  
Anterior mediastinal mass and a thyroid mass in the same patient is very uncommon and more so in a patient coming for an orthopaedic surgery as was the case in our patient.Mediastinal mass could be absolutely benign to highly malignant and hence require prompt diagnosis. When presenting for diagnostic/definitive surgery or an unrelated surgery they pose serious challenges for the anaesthetist depending on its size, anatomical situation and involvement ofand pressure exerted on the various
more » ... n the various structures of the mediastinum. By nature of their anatomical location, mediastinal masses can cause compression of the heart, large vessels, carina and main bronchi. A large thyroid mass causes difficulty in securing airway due to deviation and compression of trachea. Successful management requires assessment of the effects produced by the mass and preparedness for a difficult airway .A foresight of the problems that may arise because of both these masses on induction of anaesthesia,muscle relaxation and the lateral position required for fracture humerus is important. Complications' resulting from the surgical procedure also requires good intraoperative vigilance.
doi:10.9790/0853-150775862 fatcat:zssddx72njczhk37gzuis4f3ny