Tracheal Cuff Rupture During Conventional Total Thyroidectomy: An Unusual Complication

One of the most common surgical procedures performed worldwide is thyroidectomy. Although thyroid surgery is generally accepted as a safe surgery, its complications are still not uncommon. But a tracheal cuff rupture during conventional total thyroidectomy due to a surgical needle injury is a very unusual complication. In this report, we present uneventful anesthesia management of a case without re-intubation whose endotracheal tube cuff was ruptured during conventional total thyroidectomy due to surgical needle injury. Two hours and 15 min after commencing the operation, the tidal volume decreased abruptly and we detected that the pilot balloon of the endotracheal tube was collapsed. A surgical team was informed, and they stated that the endotracheal tube cuff may be damaged with a surgical needle injury during a particular step of the operation. Anesthesia was maintained with increased oxygen flow and increased fractional inspired oxygen without reintubation. After extubation, the rupture of the endotracheal tube cuff was confirmed by concomitant deflation of endotracheal tube cuff during the inflation of the pilot balloon and observing air bubbles from a laceration on the upper part of the balloon in water. An attentive communication between surgery and anesthesia team members is crucial for better outcomes, especially in case of unusual situations.