Management of the compromised airway and the role of tracheostomy in anaplastic thyroid carcinoma.

Abstract

Introduction Anaplastic thyroid carcinoma (ATC) is an uncommon thyroid malignancy with a poor prognosis. American Thyroid Association guidelines acknowledge the complexity of airway management in these patients. We studied our local experience with the aim of providing guidance in airway management in ATC. Methods Patients with histologically confirmed ATC from January 2004 - December 2011 were identified from our institutional database. The data was retrospectively analyzed using hospital case notes. Results 26 patients were identified with ATC, 25 of which died from the disease. 5 out of 26 patients (19%) had stridor at presentation. A further 6 out of 26 (23%) developed stridor during or soon after radiotherapy. 9 patients (36%) died from airway obstruction. Conclusion Tracheotomy can facilitate completion of palliative treatment in those patients with ATC and stridor. Given the short life expectancy of these patients, a balanced decision must be made regarding the role and timing of tracheotomy. Head Neck, 2014.