CASE REPORT article
Front. Med.
Sec. Intensive Care Medicine and Anesthesiology
This article is part of the Research TopicUnderstanding diseases of central and peripheral airways: Challenges and management strategiesView all articles
Case Report: Emergency management of difficult airway in a thyroid cancer patient with undiagnosed tracheal diverticulum preoperatively and literature review
Provisionally accepted
- 1Guangzhou University of Chinese Medicine, Guangzhou, China
- 2Maoming People's Hospital, Maoming, China
- 3Guangzhou University of Traditional Chinese Medicine First Affiliated Hospital, Guangzhou, China
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Tracheal diverticulum, a rare chronic airway pathology characterized by cystic outpouchings from the trachea or main bronchi, has scant epidemiological documentation. We present a thyroid cancer case with known airway stenosis but an undiagnosed tracheal diverticulum. Perioperatively, repeated displacement of the endotracheal tube into the undiagnosed diverticulum caused critical intubation failure and complicated tracheostomy. Under fiberoptic bronchoscopic guidance, the tracheal tube was successfully advanced past a right subglottic diverticular orifice into the left tracheal lumen, achieving secure placement in the true tracheal cavity. Our retrospective analysis of published cases further characterizes pathological features. For elective surgery patients with suspected tracheal diverticulum, particularly those with prior cervical surgery or pathology, we strongly advise preoperative bronchoscopy to confirm the defect and develop tailored airway management. This case also demonstrates that transnasal fiberoptic bronchoscope-guided intubation effectively rescues unanticipated difficult airways during tracheal diverticulum-related reintubation.
Keywords: Airway Management, case report, fiberopticbronchoscopy, thyroid cancer, Tracheal diverticulum
Received: 04 Nov 2025; Accepted: 08 Dec 2025.
Copyright: © 2025 Chen, Cai, Li and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yong Wang
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