Document Detail


Equal and opposite expert opinion. Airway obstruction caused by a retrosternal thyroid mass: management and prospective international expert opinion.
MedLine Citation:
PMID:  21486272     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Anticipated problems with airway management during anaesthesia require careful planning, particularly when they involve a risk of airway obstruction. Advice may be sought from published literature (usually written by experts) or through direct communication with experts. More frequently, expert involvement is through retrospective review following patient harm. We present the case of a patient suffering from a retrosternal thyroid mass that was compressing her trachea in the midline and dividing it into two 2 × 3 mm lumens. After local discussion the patient underwent thyroidectomy. We invited international experts in anaesthetic airway management to review her case and submit their opinions regarding the best airway management for this difficult case. Opinions differed markedly, mirroring the published literature. Some experts specifically criticised techniques that, unbeknown to them, were proposed by others. The case raises issues about the nature of expert opinion that extends beyond this particular case. The nature and implications of expert opinion, when evidence is absent or conflicting, are discussed.
Authors:
T M Cook; P J Morgan; P E Hersch
Publication Detail:
Type:  Case Reports; Journal Article     Date:  2011-04-12
Journal Detail:
Title:  Anaesthesia     Volume:  66     ISSN:  1365-2044     ISO Abbreviation:  Anaesthesia     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-08-11     Completed Date:  2011-10-07     Revised Date:  2011-12-15    
Medline Journal Info:
Nlm Unique ID:  0370524     Medline TA:  Anaesthesia     Country:  England    
Other Details:
Languages:  eng     Pagination:  828-36     Citation Subset:  AIM; IM    
Copyright Information:
© 2011 The Authors. Anaesthesia © 2011 The Association of Anaesthetists of Great Britain and Ireland.
Affiliation:
Department of Anaesthesia, Royal United Hospital, Bath, UK. timcook007@googlemail.com
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MeSH Terms
Descriptor/Qualifier:
Airway Obstruction / etiology*,  therapy
Expert Testimony
Female
Goiter, Nodular / complications*
Humans
Intubation, Intratracheal
Laryngeal Masks
Middle Aged
Thyroidectomy / methods
Comments/Corrections
Comment In:
Anaesthesia. 2011 Dec;66(12):1174; author reply 1174-5   [PMID:  22070590 ]
Anaesthesia. 2011 Dec;66(12):1172-3; author reply 1173-4   [PMID:  22070587 ]

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