Pathophysiology of airway obstruction caused by wound hematoma after thyroidectomy: an ex vivo study
Background: Airway obstruction by postoperative hemorrhage after thyroid resection is a serious adverse and potentially life-threatening event. The aim of this study is to investigate if the possible pressure caused by a postoperative hematoma in the neck would be sufficient to compress the trachea and therefore leads to a mechanical airway obstruction.
Methods: In this ex vivo model varying pressures (0–250 mmHg) were applied on 30 human cadaver tracheas. The primary outcome was the anterior-posterior and latero-lateral tracheal diameter during the application of different pressures.
Results: At the highest pressures of 250 mmHg, there was an average compression of only 67.80 % in anterior-posterior direction and of 60.09 % in latero-lateral direction.
Conclusions: This study suggests that even pressures of 250 mmHg in neck-hematomas would be insufficient to cause a mechanical airway occlusion.
Dr. med. T. von Ahnen, Dr. med. M. von Ahnen, Dr. med. U. Wirth, A. Schroll, Prof. Dr. med. H. M. Schardey, PD Dr. med. S. Schopf, European Surgery 3/2015