Challenges for a perioperative physician – A choking thyroid planned for total thyroidectomy

A large retrosternal goiter is a nightmare for an anesthesiology and a surgeon. A comprehensive history, a thorough clinical examination, pre-operative planning and a close working relationship among multidisciplinary medical teams are prerequisites to prevent adverse events intra-operatively and postoperatively. This case report is about a geriatric patient who presented with progressively enlarged anterior neck swelling for past 30 years associated with orthopnea and dysphagia. Patient underwent awake fibreroptic intubation under topical anesthesia. Thyroidectomy combined with sternotomy was done. Intra-operative and postoperative was uneventful.This case report suggests the use of AFOI in anticipated difficult airway and it’s success.