Q:

A 44 year old patient has sudden onset of breathlessness and stridor few minutes after extubation for thyroidectomy. The patient had longstanding goiter for which he had the surgery. What is the most likely diagnosis?

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A 44 year old patient has sudden onset of breathlessness and stridor few minutes after extubation for thyroidectomy. The patient had longstanding goiter for which he had the surgery. What is the most likely diagnosis?


  1. Thyroid storm
  2. Hematoma
  3. Unilateral recurrent laryngeal nerve injury
  4. External laryngeal nerve injury
  5. Tracheomalacia

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The key is E. Tracheomalacia. [Tracheomalacia is a process characterized by flaccidity of the supporting tracheal cartilage, widening of the posterior membranous wall, and reduced anterior- posterior airway caliber. These factors cause tracheal collapse, especially during times of increased airflow, such as coughing, crying, or feeding. Prolonged pressure over trachea by goiter is a cause of tracheomalacia following thryroidectomy].

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