what are causes of dyspnea in thyroid disorders?

[القصرعينية]

what do u know about that question?

:smiley25:

[Eman Samir]

one of the causes- i think- is retrosternal extension,
tracheomalacia may also cause postoperative stridor in long standing cases.
also it is considered one of the pressure symptoms

am i right??

[kalamntena]

يا القصرعينية
السؤال ده جامد قوى
انت عايزة اسباب الامراض كلها
مبدئيا
لازم نحدد ايه الامراض اللى ممكن تصيب الغدة الدرقية
وبعدين نشوف اى منها يسبب اختناق كسبب اساسى
او كمضاعفات
او كمضاعفات للعلاج
ده سؤال تقيل قوى

[مصباح]

ينفع يعني نقول واحده عندها thyrotoxicosis
جوزها زهق منها من عصبيتها
و هيه كمان اتخنقت منه
ينعني جالها dyspnea
!!!
just kidding

[مصباح]

إيمان قالت كل اللي انا اعرفه
أنا متشوق للمزيد

[فيرون]

can't thyroid causes pulmonary congestion by increased cardiac output -to this extenthttp://www.elkasrelaini.com/english/students/forum/images/smilies/innocent.gif ?? mmm -? I do not know!
thyroid haematomas, retrosternal extension, invasion of trachea and tracheomylacia may cause tracheal narrowing or compression. palpitations / felt arrythmia that increase fear of death http://www.elkasrelaini.com/english/students/forum/images/smilies/smiley15.gif may cause dyspnea !!
Hashimoto's thyroiditis may cause traction http://www.elkasrelaini.com/english/students/forum/images/smilies/huh.gif
Cretinism causes obesity which is a risk factor directly or indirectly to dyspnea http://www.elkasrelaini.com/english/students/forum/images/smilies/wacko.gif
postoperative fibrosis/ strictures
lingual thyroid !!http://www.elkasrelaini.com/english/students/forum/images/smilies/sorcerer.gif as a cause of obstructing oropharynx
may bilateral irritation of recurrents by the disease or operatively or unilaterally with previously diseased other recurrent cause dyspnea ?http://www.elkasrelaini.com/english/students/forum/images/smilies/zain.gif
؟

[فيرون]

cachexia
surgery
lymphoma
hyperventillation
ANY BODY KNOWS ?

[القصرعينية]

Eman i agree
kalamntena أنا عاوزة الأمراض المسببة كلها، وبعدين انت قدها وقدود
مصباح فكرتني بحكاية قالهالنا دكتور في الوحدة ان شاء الله نذكرها
Veron i agree except

palpitations / felt arrythmia that increase fear of death http://www.elkasrelaini.com/english/students/forum/images/smilies/smiley15.gif may cause dyspnea !!
Hashimoto's thyroiditis may cause traction http://www.elkasrelaini.com/english/students/forum/images/smilies/huh.gif
Cretinism causes obesity which is a risk factor directly or indirectly to dyspnea http://www.elkasrelaini.com/english/students/forum/images/smilies/wacko.gif
postoperative fibrosis/ strictures

well till now what i know is:
congenital: ectopic ligual thyroid
inflammatory: riedel's thyroiditis
simple nodular goitre due to:
tracheal kink
antro-posterior slit (scabbard trachea)
tracheomalacia
haemorrhage inside a cyst leading to spasm of pretracheal muscles
Thyrotoxic goitre due to:
High cardiac output heart failure
exertional dyspnea
thyrotoxic crises
thyroid cancer due to:
infiltration of the trachea
unilateral infiltration of RLN
pleural effusion
retro-sternal goitre

so what do we know about the post-operative causes?

[فيرون]

I insist on all http://www.elkasrelaini.com/english/students/forum/images/smilies/happy.gif
http://www.elkasrelaini.com/english/students/forum/images/smilies/smiley23.gif
http://www.elkasrelaini.com/english/students/forum/images/smilies/ugga.gif

[القصرعينية]

my point of view is:

palpitations / felt arrythmia that increase fear of death http://www.elkasrelaini.com/english/students/forum/images/smilies/smiley15.gif may cause dyspnea !!
this is a psychic cause can occur in many situations not specific for thyrotoxic patients

Hashimoto's thyroiditis may cause traction professor is asked & said it is not a cause

Cretinism causes obesity which is a risk factor directly or indirectly to dyspnea i don't know

[فيرون]

thyroiditis may cause traction ;

sorry, I do not knowhttp://www.elkasrelaini.com/english/students/forum/images/smilies/smiley6.gif but, that which is associated with extensive adhesions and fibrosis .http://www.elkasrelaini.com/english/students/forum/images/smilies/huh.gif

[القصرعينية]

1.RLN injury (unilateral "partial or complete", bilateral"partial")
2.haematoma around trachea
3.tracheomalacia from prolonged compression.
4.tetany due to removal of parathyroid glands or interferance with thier blood supply.
5.Thyrotoxic crisis.

:twins: ودمتم

[القصرعينية]

a female patient had a subtotal thyroidectomy operation, after the operation the doctor was surprised when he saw the patient's husband coming to thank him for what he did..ده انت خدمتني خدمة العمر يا دكتور:icon_mrgr

so the doctor asked : خير؟

زوج العيانة: أصل مراتي الحمد لله بقت كويسة وغير كده كمان كل ما تيجي تزعق صوتها يروح

بس طبعا لسوء نية الزوج الوفي:yadmaghy: صوت الست رجع :health: في خلال شهور



what do u think has happened ?

[مصباح]

does the RLN resolute after injury ??

[القصرعينية]

it is not RLN

but generally what i know is a nerve injury can resolve spontaneously if axonotemesis or neuropraxia ,while it can't if neurotemesis

[القصرعينية]

no other guessings?!!!!!!!!!!!!!!!!!

[مصباح]

مداخلة سريعة :


Causes of respiratory distress (dyspnea) after thyroidectomy :



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A : once extubated ( just after removal of endotracheal tube ) :


1 – tracheomalacia


2- laryngeal spasm ( laryngismus stridulus )


3- bilateral incomplete RLN injury


B : few hours after the operation :


1 – tension hematoma أهم حاجة


2- laryngeal edema (due to intubation specially in high vascular goiter )


C : few days after operation :


1- hypocalcemia


2- thyroid storm


الإجابة من مذكرة د.حسين خيري
إيه بقى الحل ؟

[القصرعينية]

:smiley20: thanks mesbah (very oriented)
but i will give more time for people to think

[admin]

Dr. Amr Mohsen Gave me an answer via mail;
Look up our book in "endocrine surgery" chapter, thyroidectomy operation (follows thyrotoxicosis treatment), and then postoperative complications. You will find:
1. Reactionary hge and formation of haematoma (most important
2. Bilateral recurrent nerve injury
3. Laryngeal oedema
4. Tracheomalacia
If a student briefly mentions general causes, well and good. If not no harm done

[القصرعينية]

what about the case people?

[فيرون]

I think Dr. Amr Answer was on ; Post-operative complications not the all disorders

[مصباح]

yes, .. sure

[القصرعينية]

again:
what about the case people?

[القصرعينية]

again:
what about the case people?
خدوا الكم:لما بتزعق صوتها بيروح

[القصرعينية]

again:
what about the case people?
خدوا بالكم:لما بتزعق صوتها بيروح

[مصباح]

??????????????????????????????

[دولسيكا]

متهيألى انتى كدة حلتيها يا قصر عينية
لما بتزعق صوتها بيروح!!!؟
what about the external laryngeal nerve
حد عرف أنا أقصد ايه
:smiley29:

[القصرعينية]

:smiley32: ألف مبرووووووووووووووك

انتي فين من زمان يادولسي..
تمام كده لأن
external laryngeal nerve supplies cricothyroid muscle responsible for high pitched voice

طب نيجي للجزء التاني من السؤال
صوت الست رجع http://linux.kasralainy.com/english/students/forum/images/smilies/ugga.gif في خلال شهور

what do u think has happened ?

[دولسيكا]

قولى انتى المرة دى
اصلى مش متأكدة

[القصرعينية]

the doctor said that the nearby nerves supplied the cricothyroid muscle (coaptation)
which i think is difficult:bold: