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Year : 2019  |  Volume : 2  |  Issue : 1  |  Page : 17-21

Is neck roentgenogram essential for airway assessment in thyroid swelling? A 3-year audit in a tertiary care centre

Department of Anaesthesiology, K S Hegde Medical Academy, Mangalore, Karnataka, India

Correspondence Address:
Dr. Balaram Chandana
#28, 2nd Main, Amarjyothi Layout, Anand Nagar, R T Nagar Post, Bengaluru - 560 032, Karnataka
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ARWY.ARWY_7_19

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Introduction: Thyroid swelling leading to airway compromise offers a challenge to the anaesthesiologist. Neck roentgenograms are routinely done as a part of preanaesthetic evaluation in thyroid swellings in our institute. With this audit, we wished to analyse whether routine neck roentgenograms had any role in the airway assessment and management for thyroidectomy. Methodology: After obtaining clearance from the Institutional Ethics Committee, data of all patients who underwent thyroidectomy under general anaesthesia between January 2015 and December 2017 were collected from the Medical Records Department. We collected demographic details along with the details of anaesthetic management of these patients. Our primary objective was to know whether neck roentgenogram was essential in thyroidectomy, and the secondary objective was to analyse the airway management in these patients. Qualitative data were represented as frequencies and percentages and quantitative data as mean and standard deviation. Chi-square test was used to compare the qualitative variables and t-test for quantitative variables, and P < 0.05 was considered statistically significant. Results: A total of 317 thyroidectomies were conducted in our hospital between January 2015 and December 2017. Neck X-ray was done in 275 patients (86.75%), whereas the X-ray was not found or documented in 15 patients (5.45%). X-rays of only 42 patients (16.15%) had positive findings. In 66.7% of the cases with positive finding on neck X-ray, airway was managed with direct laryngoscopy and intubation without any difficulty. Conclusion: We conclude that neck roentgenographs are not a sensitive method for predicting difficult airway in patients with thyroid swelling and could be avoided in routine practice to decrease radiation exposure.

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