Goitre-Related Factors for Predicting Difficult Intubation in Patients Scheduled for Thyroidectomy in a Resource-Challenged Health Institution in North Central Nigeria

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Bolaji Benjamin Olusomi
Suleiman Zakari Aliyu
Adegboye Majeed Babajide
Agodirin Olayide Sulaiman
Olatoke Samuel Adegboyega
Habeeb Olufemi Gbenga
Rahman Ganiyu Adebisi

Abstract

BACKGROUND: Airway management problems may arise whenintubating patients with goitre scheduled for thyroidectomy.Goitres are not uncommon in sub-Saharan Africa, thyroidectomybeing the main treatment. The aim of this study was to determineincidences of difficult intubation (DI), failed intubation (FI)andpredictors of DI using a modified intubation difficulty score(IDS).METHODS: One hundred and twenty-five consenting patientswith goitre scheduled for thyroidectomy were recruited. Goitre-related factors (GRF) of duration of illness, diagnosis, neckcircumference, tracheal deviation and narrowing and retrosternalextension were recorded as well as Mallampati classification andBMI. At intubation, modified IDS was determined for eachpatient. Patients with modified IDS ≤ 5 were categorized as easyintubation group (E), and those with modified IDS >5 werecategorized as difficult intubation group (D). The GRF of allpatients in group D were compared with matched patients ingroup E.RESULTS: Incidence of DI was 13.6% with 2 (1.6%) cases offailed intubation. Comparing groups D and E, duration of illnesswas 4.28 ± 3.78 years in group D versus 7.44 ± 7.63 years groupE, p = 0.1353. Neck circumference was 41.42 ±5.30 cm in groupD versus 37.43±2.68 cm in group E, p = 0.0200. Trachealdeviation, narrowing and retrosternal extension, and surgicaldiagnosis were not significantly different among both groups.CONCLUSION: Incidence of DI was 13.6% and that of FI was1.6%. Neck circumference was found to be a predictor of difficultintubation in goitre patients scheduled for thyroidectomy usingthe modified IDS.

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Original Article
Author Biographies

Bolaji Benjamin Olusomi, University of Ilorin and theUniversity of Ilorin TeachingHospital, Ilorin, Nigeria

Departments ofAnaesthesia,

Faculty of Clinical Sciences,

CollegeofHealthSciences

Suleiman Zakari Aliyu, University of Ilorin and theUniversity of Ilorin TeachingHospital, Ilorin, Nigeria

Departments ofAnaesthesia,

Faculty of Clinical Sciences,

CollegeofHealthSciences,

Adegboye Majeed Babajide, University of Ilorin and theUniversity of Ilorin TeachingHospital, Ilorin, Nigeria

Departments ofAnaesthesia,

Faculty of Clinical Sciences,

CollegeofHealthSciences,

Agodirin Olayide Sulaiman, University of Ilorin andthe University of Ilorin TeachingHospital, Ilorin, Nigeria

Departments of Surgery, Faculty of
Clinical Sciences, College of Health
Sciences

Olatoke Samuel Adegboyega, University of Ilorin andthe University of Ilorin TeachingHospital, Ilorin, Nigeria

Departments of Surgery, Faculty of
Clinical Sciences, College of Health
Sciences

Habeeb Olufemi Gbenga, University of Ilorin andthe University of Ilorin TeachingHospital, Ilorin, Nigeri

Departments of Surgery, Faculty of
Clinical Sciences, College of Health
Sciences

Rahman Ganiyu Adebisi, University of Ilorin andthe University of Ilorin TeachingHospital, Ilorin, Nigeria

Departments of Surgery, Faculty of
Clinical Sciences, College of Health
Sciences