Pathophysiology of airway obstruction caused by wound hematoma after thyroidectomy: an ex vivo study

Summary 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.