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A team of doctors at Sheikh Khalifa Medical City (SKMC) has successfully performed a total thyroidectomy (removing the entire thyroid gland) on an 87-year-old patient.
The surgery poses a considerable risk for older patients as they are more likely to suffer from lung, heart and infectious complications following a thyroidectomy.
The elderly patient, Hasmik Dawood, had found it difficult to find a hospital that would treat her due to risk factors relating to her age, condition, and the critical nature of the surgery. She presented at SKMC with progressive symptoms of difficulty in breathing and swallowing due to her large goitre (an abnormally large thyroid gland). Her condition had grown to be debilitating, and when presented at SKMC, she was incapable of swallowing solid food.
Full investigations, including a neck CT scan, revealed an enlarged thyroid gland extending down into the chest with significant compression on wind and food pipes resulting in difficulty breathing and swallowing. Furthermore, the gland was also touching the heart and the aorta, the main artery that carries oxygenated blood from the heart.
Dr Mohamed Al Ali, Otolaryngology surgeon at SKMC, elaborating further on the case, said, “While the risk of a total thyroidectomy is considerably higher in the elderly, quality care and expertise in such surgeries opens this treatment avenue for such patients.
"The postoperative complications form the bulk of the risk factors, but the true risk lies in hidden underlying health conditions. In case of Hasmik, her cardiac assessment revealed a trial fibrillation (abnormal heart rhythm) and atrial stenosis (narrowing of the heart valve) which impedes blood flow from the heart to the aorta.
"Following the diagnosis, the patient was immediately referred to cardiac management and the neck surgery was delayed by three weeks. At SKMC, we ensure that patients undergo thorough examination prior to surgery to ensure that such hidden complications are diagnosed in time. The key to success in this type of surgery often lies in perioperative care.”
Following a successful total thyroidectomy by the dedicated Head and Neck Surgery team in cooperation with the SKMC’s experienced cardiac anaesthesia team, Hasmik was admitted to the Intensive Care Unit for three days of close monitoring.Eight days after the operation, she was discharged and symptom free.
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Commenting on the surgery the patient’s son, said, “I am grateful for all the doctors at SKMC, especially Dr. Mohamed Al Ali, who agreed to operate on my mother despite her age. She was in a situation where breathing was extremely difficult that left us with no option but the surgery. Thanks to the care and life-saving treatment she received at SKMC, she is now doing well and has a new lease on life.”
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