ANAESTHETIC MANAGEMENT OF HUGE THYROID SWELLING BY USING I - LMA

PRESENTATION OF CASE A 75-year-old female patient with huge thyroid swelling with Hyperthyroidism on tablet Carbimazole 5 mg BD, since 12 years was posted for total thyroidectomy. She was a known case of Diabetes on regular oral hypoglycaemic drugs. Presently she had complaints of difficulty in swallowing and change in voice. On examination she had right sided masses which were irregularly ovoid in shape, around 10*12cm in diameter, and circumvented whole right side of the neck. (fig1) Airway examination showed a three-finger breadth mouth opening, Mallampati Class 3 and restricted neck extension. IDL revealed gross shift of trachea to left with distortion of normal anatomy, vocal cord not visualized. Chest x- ray showed tracheal deviation to the left. (Fig 2). All other investigations were within normal limits. Awake fibreoptic technique for endotracheal intubation was planned