Surgical Management of Recurrent Tracheal Stenosis in the Setting of Riedel’s Thyroiditis

Abstract

Objectives:

Riedel’s thyroiditis (RT) is a rare, severe IgG4-related fibrosing inflammatory process of the thyroid gland that may present with airway obstruction, dysphagia, and/or dysphonia. Most published reports of treatment of airway obstruction from RT focus on thyroid isthmectomy to relieve compressive or restrictive symptoms, however tracheal stenosis from direct invasion is a more unusual cause of obstruction. Our objectives were to report surgical management of a case of severe, recurrent tracheal stenosis secondary to RT and to review the management of this rare condition.

Methods:

Case report of single patient with recurrent, severe tracheal stenosis secondary to RT, with literature review of similar cases.

Results:

We report a case of severe recurrent tracheal stenosis in the setting of RT managed with bilateral subtotal thyroidectomy and slide tracheoplasty, a previously unreported intervention. Review of the literature identified a single case report in which stenosis secondary to RT was successfully managed with endoscopic dilation.

Conclusions:

Tracheal stenosis is an extremely rare complication of RT. In patients with recurrent or severe tracheal stenosis secondary to RT, slide tracheoplasty may be considered after failure of endoscopic dilation.