Thyroidectomy alo Carotid Dɔwɔwɔ Le Kɔdzi ƒe Ʋu si Wokeke Ðe Edzi: Yame ƒe Ʋuʋudedi Kple Yamemɔwo Xɔname¶

Ʋumenugbagbeviɣi si le kekem ɖe enu le kɔ ƒe ŋgɔgbe alo axadzi le gaƒoƒo 6 va ɖo 72 gbãtɔwo me le thyroidectomy, parathyroidectomy, carotid endarterectomy (CEA), anterior cervical discectomy and fusion (ACDF), alo radical neck dissection megbe nye yaƒoƒomɔ̃ ƒe nudzɔdzɔ kpata si dzɔna enumake, aɖabaƒoƒo ɖesiaɖe. Esi wònye be vidzidɔa ƒe lãkusi gogloa xatsa yagbɔgbɔ, nuɖuɖutome, lãkusi ƒe aba, kple carotid-kplu ɖe lãmeka ƒe akpa si me xaxa si me mekɔ o me ta la, ʋuka alo ʋuka me ʋu si xa mililita 30 va ɖo 100 (tsi ounces 1 va ɖo 3.4) gɔ̃ hã gbãa ʋukawo kple ʋuka siwo me ʋu sina tona siwo sina toa aɖuɖɔ me la kabakaba, trɔa gbeɖiɖikawo kple epiglottis wòzua ʋuʋudedi ƒe gli si vuvu, si womate ŋu ato o ɣeyiɣi didi aɖe hafi ʋu nado to gotagome aŋekotokua me gbeɖeka. Ne dɔnɔ aɖe si ƒe kɔ le amekoko vɔ megbe la ƒe kɔ me sẽ alo le ʋuʋum, esesẽna be wòami nu, eƒe gbe me mekɔ o, eƒe dzi mefa o, alo gbɔgbɔtsixe ƒe ɖiɖi sesĩe (stridor), ƒo ka na miaƒe nutoa me tɔ xexlẽdzesi siwo wozãna kpata enumake. Ne èdi yaƒoƒomɔ̃ si le etame kple amekoko megbe nudzɔdzɔ kpata siwo do ƒome kplii la, kpɔ ɖa epiglottitis, croup, stridor, kple yaƒoƒomɔ̃ si le etame ƒe xexe kpata, . ʋu si dona le tonsilectomy megbe kple eschar slough ƒe ʋu si dona, kple Ludwig ƒe angina kple kɔ me dɔlékui goglowo.

Mègalala gbeɖe be ʋu nanyrɔ gotagome gazea alo ayɔ amekoko ƒe tsidzɔƒe si wotsɔa plastik wɔe la me hafi nàwɔ nu o; le ʋumenugbagbeviɣidɔ siwo wua ame 80 le alafa me le ʋumenugbagbeviɣidɔ megbe la, Jackson-Pratt ƒe tsidzɔƒe si wotsɔ plastik wɔe la me tsi keŋkeŋ alo edzena abe ɖe wòle ƒuƒlu blewu ene esime nyaƒoɖeamenu le dzidzim ɖe edzi le lãmekawo ƒe akpa si wotu nu ɖo la me. Dɔnɔa ƒe bolt bɔbɔ nɔ anyi ɖe tsitrenu, ɖe kɔ ƒe gotagome kaƒomɔ̃a ɖa enumake, kple duƒuƒu yi dɔwɔƒe si kpɔa nudzɔdzɔ kpatawo gbɔ hena abadzivɔ SCOOP abi ƒe ʋuʋu enumake ɖea dɔnɔa tso gbɔgbɔtsixetsixe me.

Wɔ esia fifia¶

1. Ƒo ka na wò nutoa me xexlẽdzesi kpata enumake. Ƒo ka na 911 le United States kple Canada, 112 le Europa Dukɔwo ƒe Habɔbɔ bliboa me, 999 le United Kingdom, 000 le Australia, alo nàlé ŋku ɖe míaƒe nyatakakadzraɖoƒe si nye xexlẽdzesi siwo wozãna kpata. Gblɔ na ame si ɖoe ɖa la eme nakɔ be: "Nyitsɔ laa ƒe kɔ/thyroid/carotid/cervical spine dɔwɔwɔ na kɔ me ʋu si vuvu kabakaba kple yaƒoƒomɔ̃wo ƒe tete; hiã Advanced Life Support kpekpeɖeŋunalawo enumake."
2. Na dɔnɔa ƒe bolt la nanɔ tsitrenu le dzidzenu 45 va ɖo 90 (high Fowler's position). Mègazi dɔnɔ si ƒe kɔ vuvu le amekoko vɔ megbe dzi gbeɖe be wòamlɔ anyi gbadzaa ɖe woƒe akɔta. Mlɔ anyi gbadzaa nana be nuheŋusẽ kple ʋukawo ƒe nyaƒoɖeamenu si dzi ɖe edzi la xɔa kɔ ƒe ʋumenugbagbeviɣidɔa eye wònaa aɖe ƒe gɔme si vuvu kple epiglottis la ɖiɖina ɖe megbe ɖe yaƒoƒomɔ̃ si wote ɖe edzi la ŋu, si wɔnɛ be yaƒoƒomɔ̃ bliboa tu enumake.
3. Ðe kɔ ƒe gotagome aŋe siwo katã sesẽ, nyaƒoɖeamenu, kple aŋenu si wotsɔna léa nu ɖe ​​nu ŋu la ɖa enumake (eye nàɖe vidzidɔ ƒe kɔla sesẽ ɖesiaɖe ne vidzidɔa ƒe akɔta ƒe liƒo ɖe mɔ alo abe alesi EMS gblɔe ene). Mègabla **megatsɔ aŋe si te ŋu trɔna ɖe kɔ si vuvu la ŋu o, eye mègatsɔ wò asiwo te sesĩe ɖe yaƒoƒomɔ̃a ƒe ŋgɔgbe tẽ o (trachea) be "woatɔ te ʋu si le dodom." Ne wozi kɔ si woɖe le ʋumenugbagbeviɣidɔ megbe ƒe ŋgɔgbe dzi la, etutua ʋu si xaxa la ɖe megbe tẽe yia megbe yia megbe yaƒoƒo ƒe gli falɛfalɛa me eye wòtsia dzodzodzoe. Ðe gotagome kasɛt la ɖa blewuu eye nàtsɔ gaze la ɖa ale be wò kple kpekpeɖeŋunalawo miate ŋu akpɔ amekokoa ƒe lãɖeɖea eye nàna ŋutigbalẽa nakeke ɖe gota.
4. Na dɔnɔa ƒe dzi dze eme, magaʋuʋu o, eye wòanye nusi me naneke mele o to nu me (naneke maɖu, ano nu, alo mimi o). Avifafa, kɔdzi, ʋuʋudedi, alo teteɖeanyi nana ʋuka siwo le titina kple ʋukawo me ʋu ƒe sisi le ʋuka siwo me ʋu sina tona me dzina ɖe edzi eye wònana ʋu sina yia kɔ ƒe akpaa me kabakaba.
5. Kpɔ amekoko ƒe tsidzɔƒe ƒe akaɖi (ne ele eme), gake MÈGAKA ɖe tsidzɔƒe ƒuƒlu dzi GBEÐE o. Ne woɖo dɔnɔa ɖe aƒeme kple Jackson-Pratt (JP) alo Blake ƒe tsinyegoe la, kpɔe ɖa be kasia akaɖi si le abe bɔmb ene la yɔ fũ kple ʋu dzĩ si le keklẽm alo eƒe vacuum pinch bu. Gake ɖo ŋku edzi be ʋu ƒoɖiwo xea do suesuesue siwo le amekoko ƒe tsidzɔƒe me edziedzi le aɖabaƒoƒo ʋɛ aɖewo ko me, si wɔnɛ be akaɖia tsia ƒuƒlu esime kɔa le ʋuʋum afɔkutɔe.
6. Ne dɔnɔa le thyroid alo parathyroid dɔwɔwɔ vɔ megbe la, ke kpɔe hã be ʋuʋudedi le nuyiwo kple asibidɛwo ŋu alo asi ƒe ʋuʋu hã (hypocalcemic laryngospasm). Ne woɖe parathyroid gland sue eneawo ɖa le vo me le thyroid dɔwɔwɔ me nana calcium ƒe agbɔsɔsɔ le ʋu me dzi ɖena kpɔtɔna le gaƒoƒo 12 va ɖo 72 le dɔwɔwɔ vɔ megbe, si wɔnɛ be nuyiwo/asibidɛwo ƒe nugbɔwo nɔa ʋuʋum, asi siwo le abe asike ene la ƒe ʋuʋu sesẽ (Trousseau's sign), kple gbeɖiɖikawo ƒe ʋuʋu kpata ( .stridor) ne ʋumenugbagbeviɣidɔ aɖeke mele eŋu o gɔ̃ hã.

Nyametsotsoti: kɔ ƒe dɔwɔwɔ vɔ megbe ƒe vuvu kple yaƒoƒomɔ̃wo ƒe vovototodedeameme¶

flowchart TD
    A["Dɔnɔ Le Thyroidectomy, Parathyroidectomy, Carotid (CEA), alo Anterior Cervical Spine (ACDF) ƒe dɔwɔwɔ vɔ megbe"] --> B{"Da kɔ ƒe dzedzeme, gbe, nu mimi, kple gbɔgbɔ kpɔ"}
    B -->|"Stridor (gbɔgbɔ sesẽ), nuyi blɔ, ʋuʋu, alo nuƒoƒo/gbɔgbɔ ƒe ŋutetemanɔamesi"| C["ƲUƲU ƑE ƲUƲU ƑE ƲUƲU SI VA GBƆNA: Ƒo ka na 911/112/999 eye nànɔ anyi ɖe dɔnɔa ƒe bolt dzi wòanɔ tsitrenu"]
    C --> D["Ðe gotagome nusi wotsɔ blae la ɖa enumake; MÈGATE ɖe yaƒoƒomɔ̃a dzi o"]
    D --> E["Hospital/EMS SCOOP Protocol: Ʋu ŋutigbalẽ KPLEE strap-muscle sutures be woaɖe ʋu si le ʋuka me la ɖa"]
    B -->|"Kɔ ƒe vuvu, eƒe ʋuʋu, eƒe yɔyɔ, gbe si me mekɔ o, alo aɖuɖɔ mimi ƒe kuxi"| F["KPEKPEÐEŊU KƆKƆE HEMATOMA (Afɔɖeɖe Gbãtɔ hafi stridor) ."]
    F --> G["Nɔ anyi ɖe tsitrenu le dzidzenu 45 va ɖo 90, ɖe tape sesẽ ɖa, lé NPO pɛpɛpɛ, yɔ EMS fifia"]
    B -->|"Nu/asibidɛwo ƒe ʋuʋu + asiwo ƒe ʋuʋu (‘asibidɛ ƒe asi’) + kɔ falɛfalɛ gbadzaa"| H["ACUTE POST-THYROIDECTOMY HYPOCALCEMIA (Afɔku si nye Tetany / Laryngospasm ƒe afɔku) ."]
    H --> I["Na calcium carbonate + calcitriol si woŋlɔ na wò ne ète ŋu mi; yi ER hena IV calcium gluconate"]
    B -->|"Mo ƒe akpa ɖeka ƒe ŋeŋe kpata, abɔ ƒe gbɔdzɔgbɔdzɔ, alo nuƒoƒo si me mekɔ o le Carotid Dɔwɔwɔ vɔ megbe"| J["POST-CEA STROKE ALOO CAROTID THROMBOSIS: Yɔ EMS enumake"]

Alesi kɔ me ʋu sue aɖe nana yaƒoƒomɔ̃wo tu kpata¶

Dɔnɔ geɖe kple ƒomea me tɔwo tsɔe be ne ʋuka aɖe te ʋu le dodom le kɔ ƒe dɔwɔwɔ vɔ megbe la, yewoakpɔ ʋu si le dodom le akɔta, alo be ʋu gbogbo aɖe hiã hafi woate ŋu agbã yaƒoƒomɔ̃a ƒe ƒunukpeƒewo. Nukpɔsusu evea siaa nye alakpa eye wowua ame.

Nusita vidzidɔ ƒe lãkusi si me goglo la wɔa dɔ abe nuɖanu si wotu ene¶

Amegbetɔ ƒe kɔ ƒe ŋgɔgbe ma ɖe ŋutilã ƒe akpa siwo me mekɔ o siwo me ka siwo me ka sesẽwo mele o siwo woyɔna be dep cervical fascia (vevietɔ deep layer of deep cervical fascia, pretracheal fascia si ƒo xlã thyroid bed kple trachea, kple carotid sheath) ƒo xlãe. Ne amekola wu thyroidectomy, parathyroidectomy, alo anterior cervical spine dɔwɔwɔ nu la, zi geɖe la, wotsɔa strap lãmeka siwo le tsitrenu (sternohyoid kple sternothyroid) trɔna ɖe wo nɔewo ŋu le titina fli si le yaƒoƒomɔ̃a dzi eye emegbe wotua lãmeka si le etame (platysma) kple ŋutigbalẽ si me wotsɔa aŋe, amekoko ƒe nu veviwo, alo cyanoacrylate ŋutigbalẽ ƒe aŋetu.

Ne ʋuka si le etame, ʋuka si le ete, ʋuka si le titina, alo ʋuka si le ŋgɔgbe ƒe alɔdze aɖe ƒo eƒe ka alo ʋu ake ne dɔnɔa kɔ akɔta, ʋu, alo tete ɖe edzi le alɔ̃dɔdɔ vɔ megbe la, ʋu kɔna ɖe teƒe si wotu do ŋgɔ na yaƒoƒoa le yaƒoƒomɔ̃a tame tututu. Esi wònye be ka ƒe lãmeka siwo wotsɔ lãfu wɔe kple vidzidɔ ƒe lãkusi sesẽ mate ŋu akeke ayi gota bɔbɔe o ta la, nyaƒoɖeamenu si le xɔ sia si wotu me dzina ɖe edzi ŋutɔ (cervical compartment syndrome).

Mɔnu eve siwo wua ame siwo xea mɔ na yaƒoƒomɔ̃wo¶

Kɔ me ʋu si le kekem ɖe enu la xea amegbetɔ ƒe yaƒoƒomɔ̃ to ŋutilã ƒe mɔnu vovovo eve dzi - eye mɔnu eveliae nye esi léa atikewɔla bibiwo gɔ̃ hã le vo me:

1. Mɔ̃ ƒe nutete tẽ si le megbeƒu ƒe lãkusi ŋu: Togbɔ be hyaline ƒunukpeƒe ƒe asigɛ siwo le abe C ene lé yaƒoƒoa ƒe ŋgɔgbe kple axawo ɖe te hã la, yagbɔgbɔ ƒe megbegli (pars membranacea) - si nɔa anyi ɖe nuɖuɖutome kple prevertebral spine ŋu tẽ - wotsɔa fibromuscular membrane falɛfalɛ si te ŋu trɔna bɔbɔe eye ƒunukpeƒetetedɔ aɖeke mele eŋu o. Ne ʋu ƒe sisi le ƒoƒom ɖe yaƒoƒo do ŋgɔ kple yaƒoƒo ƒe akpa siwo le yaƒoƒoa megbe la, ʋumenugbagbeviɣia ƒoa yaƒoƒoa tso ŋgɔgbe kple axadzi eye eblaa megbeƒu ƒe gli falɛfalɛa yia eme, si wɔnɛ be yaƒoƒomɔ̃a ƒe doa dzi ɖena kpɔtɔna.
2. Venous kple lymphatic strangulation si hea pharyngolaryngeal mucosal edema gã aɖe vɛ (Amewula Nyateƒetɔ):
3. Ʋukawo me ʋu gena ɖe lãkusi kple gbeɖiɖikawo me le nyaƒoɖeamenu sesẽ (90 va ɖo 120 mmHg), esime ʋuka me ʋu kple ʋukawo dona le ʋuka me to ʋuka siwo le gli tsɛ, siwo ƒe nyaƒoɖeamenu sue le ememe jugular kple thyroid veins (5 va ɖo 15 mmHg ko) me.
4. Ne nyaƒoɖeamenu le lãkusi ƒe aba si wotu nu ɖo me ko la, ʋumenugbagbeviɣia wu 15 va ɖo 20 mmHg ko la, ʋukawo kple ʋukawo me tsi si dona tso lãkusi, gbeɖiɖikawo, arytenoids, kple epiglottis me tso keŋkeŋ, esime ʋukaawo yia edzi nɔa tsi tom ɖe eme.
5. Tsi sina dona tso lãkusi ƒe ʋuka siwo xaxa me yia lãkusi te siwo le gbadzaa siwo le supraglottis kple gbeɖiɖikawo me. Le miniti 15 va ɖo 45 me la, epiglottis kple alakpa gbeɖiɖikawo zua goglo gã siwo le keklẽm, siwo me tsi yɔ fũ (massive laryngeal edema) siwo xea yaƒoƒomɔ̃ si wotu tso eme la nu - eye wònana kɔdzi ƒe endotracheal intubation si wozãna ɖaa la mate ŋu adzɔ kloe o negbe ɖe wotso kɔ ƒe ʋuƒoawo gbã be woaɖe ʋuka ƒe nyaƒoɖeamenua dzi akpɔtɔ hafi.

Nukatae wowɔa ʋu ƒe sisi ƒe oximetry ( .SpO2) kple stridor nye dzesi siwo nye LATE siwo me afɔku le¶

Ame tsitsi ƒe yaƒoƒo si le lãmesẽ me ƒe ememe kekeme nye milimeta 15 va ɖo 20 (inch 0.6 va ɖo 0.8). Elabena ya ƒe sisi ƒe tsitretsitsi to mɔ̃ si le gbadzaa me sɔ kple ŋusẽ enelia si le didime (Poiseuille's law), dɔnɔ si le gbɔgbɔm kpoo le ɖiɖiɖemeɣi la akpɔ oxygen ƒe agbɔsɔsɔ si sɔ bliboe (98% va ɖo 100% le asibidɛ ƒe ʋuʋu ƒe oximeter dzi) eye stridor mase o vaseɖe esime woƒe yaƒoƒomɔ̃ ƒe didime si wu 70 le alafa me xe xoxo.

Ne yaƒoƒomɔ̃a nya xaxa va ɖo eƒe milimeta 4 va ɖo 5 (inch 0.16 va ɖo 0.2) mamlɛtɔ ko la, ya ƒe sisi si me tɔtɔ le la nana gbɔgbɔtsixe ƒe stridor si ƒe gbeɖiɖi kɔ ŋutɔ la dona, dɔnɔa tsia dzodzodzoe eye wògbɔa ya sesĩe wu, akɔta ƒe nutete manyomanyo hea gbeɖiɖika siwo vuvu la ɖekae keŋkeŋ (Venturi ƒe ŋusẽkpɔɖeamedzi), eye gbɔgbɔtsixe tsia ƒo keŋkeŋ le miniti eve va ɖo etɔ̃ me. Mègalala stridor alo oxygen ƒe nuxexlẽ si mebɔ o gbeɖe o; wɔ nu ne kɔ ƒe tete, vuvu, alo nu mimi sesẽ ƒe dzesi gbãtɔ ŋutɔ.

Ɣeyiɣi ƒe ɖoɖo kple afɔku ƒe fesrewo le kɔ ƒe dɔwɔwɔ vɔ megbe¶

Nuxlɔ̃amedzesiwo do ŋgɔ vs. megbe: "DESATS" ƒe dɔdaƒe ƒe ɖaseɖigbalẽ¶

Britaintɔwo kple dukɔwo dome lãmenugbagbeviwo ƒe dɔwɔwɔ na ame ƒe mɔfiamewo zãa ŋkuɖodzinu DESATS tsɔ naa hehe dɔnɔdzikpɔlawo, dɔnɔwo, kple ƒomedzikpɔlawo be woakpɔ kɔ me ʋu si le kekem ɖe enu hafi stridor nadze egɔme:

• D - Nu mimi sesẽ (Dysphagia) alo vevesese: Kasia dɔnɔa sena le eɖokui me abe golf-bɔl alo ka sesẽ aɖe le woƒe ŋɔti tem ene ne ele agbagba dzem be yeami yewo ŋutɔ yewoƒe aɖuɖɔ, alo dzea aɖuɖɔ dodo gɔme elabena mimi le veve sem. Zi geɖe la, esia nyea dzesi gbãtɔ ŋutɔŋutɔ, si dzena gaƒoƒo ɖeka hafi gbɔgbɔtsixe tsia ame ƒo.
• E - Nuxlɔ̃ame kaba ƒe dzesi / vitals shift: Dzi ƒe tsotso ƒe dzidziɖedzi si womeɖe o (tachycardia over 100 bpm), ʋu ƒe sisi ƒe dziyiyi (tso adrenaline kple vevesese gbɔ), alo gbɔgbɔtsixe ƒe dzidziɖedzi (over 20 breaths per minute).
• S - Vuvu: Blibo si wokpɔna alo si woate ŋu akpɔ kple asi, fuɖeɖe, sesẽ, alo do si le do si sɔ la ƒe bu (suprasternal notch) le kɔ ƒe ŋgɔgbe ƒe gɔme, alo abi si kaka yi dzi ɖo ta asike gbɔ alo yi anyime va ɖo akɔta.
• A - Dzimaɖitsitsi, zitɔtɔ, alo dziɖeleameƒo: Dɔnɔ si kasia mete ŋu mlɔa anyi kpoo o, hea woƒe kɔdziwu alo kɔla, tea tɔ ɖe edzi be yeanɔ anyi ɖe tsitrenu, alo gblɔ be "Nane se le eɖokui me be megblẽ o, mese le ɖokuinye me abe ɖe wole nu ƒom nam ene" le ya ƒe dɔwuame kple yaƒoƒo ƒe nyaƒoɖeamenu si nye hypoxic/hypercapnic me tom kaba. Mègabu dzimaɖitsitsi le kɔ ƒe dɔwɔwɔ vɔ megbe gbeɖe be enye vɔvɔ̃ alo na atike siwo naa ame ƒe dzi dzea eme o.
• T - Tachypnea / gbɔgbɔ sesẽ: Gbɔgbɔ kpui, ehiã be woabɔbɔ ɖe ŋgɔ hafi agbɔ, alo gbe ƒe tɔtrɔ (muffled "hot-potato" gbe alo hoarseness yeye).
• S - Stridor (LATE SIGN): Gbeɖiɖi sesẽ, hadzidzi, ɣlidodo alo ɣlidodo si wosena ne wole gbɔgbɔm (inspiratory stridor) alo le eme kple egodo siaa (biphasic stridor), eye emegbe oxygen ƒe agbɔsɔsɔ dzi ɖena kpɔtɔna (SpO2).

Kɔdzi "SCOOP" abadzivɔ ƒe decompression protocol gɔmesese¶

Le ƒe 2022 me la, Yamemɔ Sesẽ Habɔbɔ (DAS), British Association of Endocrine and Thyroid Surgeons (BAETS), kple ** Britain Association of Otorhinolaryngology (ENT UK)** ta mɔfiame ɖedzesi siwo tso dɔ vovovowo gbɔ siwo ɖo SCOOP ƒe ɖoɖo si wowɔ hena ʋu si woɖe le ʋumenugbagbeviɣidɔ megbe la ɖeɖe le aba dzi kpata. Ele be dɔnɔdzikpɔla ɖesiaɖe, kpekpeɖeŋunala, kple atikewɔla si kpɔa nudzɔdzɔ kpatawo gbɔ nase nusitae kple alesi esia wɔa dɔe gɔme.

Nusi SCOOP tsi tre ɖi na¶

1. S - Ŋutilã ƒe ʋuʋu: Ðe gotagome nusi wotsɔ blae, kasɛt, kple Steri-Strips ɖa keŋkeŋ be woaɖe kɔ si woɖe le amekoko me la afia esime nèle dɔnɔa bɔbɔ nɔ tsitrenu eye nèle oxygen si sina nyuie 100% nam.
2. C - Lã ƑUƑOƑO ƒe ƒuƒoƒoa ƒe aŋenuwo (alo ɖe klitsawo ɖa): Zã stitch cutters, sterile scissors, alo staple remover nàtsɔ aʋu ŋutigbalẽ si le etame kple platysma ƒe nutrenu ƒe didime bliboa to kɔ si le ete la dzi.
3. O - Ʋu lãmeka ƒe ƒuƒoƒo si goglo wu (Strap muscles): Esiae nye afɔɖeɖe vevitɔ kekeake. Zi geɖe la, ŋutigbalẽa ʋuʋu ɖeɖe dzaa mesɔ gbɔ o elabena ʋumenugbagbeviɣia xaxa te titina ƒe ka ƒe lãmeka siwo wotsɔ lãfu wɔe sesĩe (sternohyoid kple sternothyroid). Atikewɔlawo lãa duƒuƒu ƒe ka si le titina si le tsitrenu si léa ka ƒe lãmekawo ɖe wo nɔewo ŋu eye wotsɔa asibidɛwo alo aŋenu siwo me mekɔ o kakaa lãmekawo ƒe ƒodowo ɖe vovo.
4. O - Ʋu abi la eye nàɖe ʋu si le ʋuʋum la ɖa: Zã asibidɛ siwo me dɔlékui mele o alo gaze tsɔ ʋu ʋu doviviti siwo le abe jelly ene siwo le ɖiɖim ɖe yaƒoƒoa tame tẽ la do goe. Enumake, akpata ƒe nyaƒoɖeamenu ɖiɖina va ɖoa zero, ʋukawo me tsi si dona tso gbeɖiɖikawo me gadzea egɔme ake, lãkusi ƒe ʋuʋu dzea egɔme nɔa ɖiɖim, eye megbe yaƒoƒo ƒe gli gaʋuna.
5. P - Tsɔ gauze si me wode dzee si me dɔlékui mele o bla abi la bɔbɔe (mègazi yaƒoƒomɔ̃a dzi o) eye nàtsɔe ayi amekokoxɔa me enumake hena amekoko ƒe ʋusɔgbɔdɔ si ŋu kakaɖedzi le le atike si naa alɔ̃dɔdɔ ame katã me.

Nusiwo ŋu woabu etɔxɛe le amekoko ƒomevi nu: Carotid, ACDF Spine, kple Parathyroid¶

Togbɔ be thyroidectomy ye nye nusi koŋ gbɔ kɔ ƒe ʋu ƒe sisi le ŋgɔgbexɔ me tsona hã la, kɔ ƒe dɔwɔwɔ etɔ̃ bubu siwo bɔ la hea nu tɔxɛ siwo dea ame ƒe agbe afɔku me vɛ:

1. Post-Carotid Endarterectomy (CEA) Ʋu si le axadzi si kekena ɖe enu¶

Le carotid endarterectomy me la, ʋukawo ƒe amekola aɖe ʋua carotid artery si bɔ kple esi le eme le kɔa ƒe akpa ɖeka be wòaɖe ʋuka siwo me ʋu sina tona la ɖa eye wòlɔ̃a aŋe (bovine pericardium, . Dacron, alo vein) ɖe ʋuka siwo me ʋu sina tona ƒe gli si me nyaƒoɖeamenu sesẽ le la dzi.

• Nusitae ʋumenugbagbeviɣidɔ si dzɔna le CEA megbe la wóna: To vovo na ʋuka me tsi si sina toa ʋukawo me la, tsi si dona tso carotid arterial suture line si ƒe nyaƒoɖeamenu sesẽ me (suture-line blowout) tsɔa ʋuka me ʋu mililita ƒe ratusan yɔa axadzi kɔa me le ʋuka me ʋu ƒe nyaƒoɖeamenu si nye 140 va ɖo 200 mmHg me le aɖabaƒoƒo ʋɛ aɖewo ko me.
• Massive tracheal deviation: Hematoma si le akpa ɖeka la ƒoa yaƒoƒo kple lãkusi bliboa ŋusesẽtɔe wòtsoa kɔa ƒe akpa si tsi tre ɖe eŋu, si ƒoa yaƒoƒomɔ̃a le dzogoe ɖaɖɛ aɖe nu esime wòle jugular vein ememetɔ kple vagus/hypoglossal nerves tem ɖe edzi.
• Afɔku si ate ŋu axɔ ʋusɔgbɔdɔ tso gotagome nutete me: Ne wozi kɔ ƒe ʋuka si me ʋu sina tona le CEA megbe dzi sesĩe la, ate ŋu axe ʋuka si me ʋu sina tona le ememe si wodzra ɖo yeyee la alo aɖe ʋuka si le gli ŋu la ɖa tẽ ayi ahɔhɔ̃a ƒe ahɔhɔ̃meka si le titina, si ana ʋu ƒe sisi gã aɖe nadze enumake (mo/abɔ ƒe lãmetutudɔ kple aphasia). Na dɔnɔa nanɔ anyi ɖe tsitrenu, akpɔ ʋu ƒe sisi dzi ne atike si woŋlɔ nɛ la to eŋu, eye nàƒo ka na 911/112/999 enumake.

2. Ŋgɔgbe Vidzidɔ ƒe Discectomy kple Fusion (ACDF) Retropharyngeal Hematoma megbe¶

Le ACDF ƒe akɔta ƒe dɔwɔwɔ na kɔ ƒe disk si me ʋuʋudedi le me la, ahɔhɔ̃ŋutinunyalawo alo ƒumeŋutinunyalawo wɔa lãɖeɖe ɖe kɔa ƒe ŋgɔgbe, hea yagbɔgbɔ kple nuɖuɖutome ɖe axadzi, ɖea diski la ɖa, eye wotsɔa titanium-gba ƒua ɖe vidzidɔa ƒe akɔtaƒu ƒe ŋgɔgbe (C3 to C7).

• Deep prevertebral / retropharyngeal space entrapment: Ʋu si dona tso ƒu ƒe aba alo superior/inferior thyroid vessels me ƒoa ƒu ɖe nuɖuɖutome kple yaƒoƒo ƒe megbe goglo le retropharyngeal space me tututu ɖe vidzidɔ ƒe akɔta sesẽa ŋu.
• Kɔ ƒe vuvu le gota ate ŋu adze abe ɖe wòle bɔbɔe bebletɔe ene: Esi ʋua xaxa ɖe akɔta goglo le nuɖuɖutome megbe ta la, kɔa ƒe gota ate ŋu adze abe ɖe wòyɔ fũ vie ko ene esime kasia dɔnɔa megate ŋu mia aɖuɖɔ o (aphagia), eɖea aɖuɖɔ, eye wòxɔa gbɔgbɔtsixe ƒe ʋuʋu sesẽ aɖe.
• Vidzidɔ ƒe kɔla sesẽ dzi kpɔkpɔ: Ne dɔnɔa do plastic vidzidɔ ƒe kɔla sesẽ (Aspen alo Miami J kɔla) si le kɔ si le vuvum kabakaba la ƒom, ɖe Velcro-ka siwo le ŋgɔgbe la ɖa eye nàɖe kɔla ƒe afã si le ŋgɔgbe la ɖa esime nèle dɔnɔa ƒe ta kple kɔ dzi lém ɖe te le nɔnɔme si me womedea akpa aɖeke dzi le o me kple afɔkpa siwo woxatsa alo akɔtaɖonuwo le axa eveawo ale be kɔa ƒe ŋgɔgbe natsi keŋkeŋ.

3. Le Thyroidectomy megbe / Parathyroidectomy Hypocalcemia vs. Laryngeal Nerve Palsy si gbugbɔna¶

Menye dɔnɔ ɖesiaɖe si woɖe le ʋumenugbagbeviɣidɔ megbe si gbɔgbɔ toɣliɖeɖe le o ( .stridor) ƒe ʋumenugbagbeviɣidɔ aɖe le eŋu. Amekoko ƒe kuxi eve siwo me ʋu mele o hã ate ŋu ahe stridor sesẽ vɛ ne kɔa ŋutɔ le gbadzaa keŋkeŋ eye wòfa:

Alesi woade vovototo ʋumenugbagbeviɣidɔ si mewɔa dɔ nyuie o le amekoko megbe kple ʋumenugbagbeviɣidɔ si me afɔku le dome¶

Le ŋkeke 3 kple 14 le kɔ ƒe dɔwɔwɔ vɔ megbe dome la, dɔnɔ geɖe dea dzesi tsi falɛfalɛ aɖe si le ʋuʋum, si me vevesese aɖeke mele o le ʋuʋudedi si le dɔyɔyɔa te tẽ si nɔa tɔtrɔm vie abe tsi ƒe ʋuʋudedi sue aɖe ene. Vovototo si le seroma si megblẽa nu le ame ŋu o kple hematoma alo kɔ ƒe ʋuʋudedi goglo si tsi megbe dome gɔmesese xea mɔ na vɔvɔ̃ esime wòle nɔnɔme kpata ŋutɔŋutɔwo lém:

• Harmless Postoperative Seroma: Tsi si me kɔ si le ɣie si le ʋuka me/ʋu me tsi si ƒoa ƒu vivivi le ŋkeke geɖe le tsidzɔƒea ɖeɖe vɔ megbe. Ŋutilã si le seroma dzi la fa, fa miamiamia, eye eƒe amadede sɔ; ne ète ɖe eŋu blewu la, esena le eɖokui me abe tsi falɛfalɛ ƒe akɔtaɖonu ene; mesesẽna na dɔnɔa be wòami aɖuɖɔ o, gbe metrɔna o, eye wògbɔa ya agbagbadzedzemanɔmee kura ne emlɔ anyi alo bɔbɔ nɔ anyi. Seroma suewo gaxɔa wo ɖokui le kwasiɖa 2 va ɖo 4 me alo amekola ate ŋu agbɔ wo le atikewɔƒe yiyi edziedzi me.
• Ʋudɔ si tsi megbe (Ŋkeke 2 va ɖo 10, vevietɔ le ʋumenugbagbeviɣitikewo gbugbɔgadze megbe): Dɔnɔ siwo gadze apixaban, rivaroxaban, dabigatran, warfarin, clopidogrel, alo heparin si wozãna tsɔ daa dɔ gɔme le gaƒoƒo 48 va ɖo 72 le kɔ ƒe dɔwɔwɔ vɔ megbe la ate ŋu axɔ ʋu evelia kpata ɖe amekokoa ƒe aba dzi. Kɔa va zua sesẽ, sesẽna, fafɛ, eye wòlolona vivivi le miniti 30 va ɖo 120 me, eye zi geɖe la, aŋɔ si ƒe amadede nye aŋutiɖiɖi-yibɔ kaka ɖe kɔme, ŋɔti me yɔ fũ, kple nu mimi ƒe kuxi kpena ɖe eŋu. Dzudzɔ ʋuɖemɔ̃a enumake, nɔ anyi ɖe tsitrenu, eye nàyi xɔ si me wowɔa dɔ kpata le la me tẽ.
• Postooperative Deep Neck Wound Abscess (Ŋkeke 4 va ɖo 14): Vevesese si le ƒoƒom, si kaka dzobibi (cellulitis), dzoxɔxɔ, dzoxɔxɔ si wu Celsius dzidzenu 38.0 (Fahrenheit dzidzenu 100.4), alo alilikpo me ʋuʋudedi si ʋẽna lilili si le sisim le lãgbalẽgoloawo alo Steri-Strips dome. Esi wònye be dɔlékui siwo le teƒe si do ŋgɔ na yaƒoƒoa me ate ŋu akplɔe ayi anyime tẽ ayi akɔta ƒe do (descending necrotizing mediastinitis) ta la, kɔ ɖesiaɖe si me dɔlékuia le la hiã be woatsɔ dɔlékuiwutikewo ade kɔdzi gbemagbe ke eye woaɖe tsi le amekoko me.

Aƒeme beléle dedie le gaƒoƒo 72 gbãtɔ siwo wowɔ le ʋumenugbagbeviɣidɔ alo ʋumenugbagbeviɣidɔ ƒe dɔwɔwɔ le kɔdzi megbe¶

Ne woɖe asi le dɔnɔ aɖe ŋu le aƒeme le ŋkeke ma ke dzi alo ŋdi si woɖe hemithyroidectomy, parathyroidectomy, alo vidzidɔ ƒe akɔta ƒe dɔwɔwɔ vɔ megbe la, aƒeme afɔɖeɖe ene dzi wɔwɔ pɛpɛpɛ ɖea afɔku si le ʋuka si wobla ɖe kɔ me si wobla me dzi kpɔtɔna ŋutɔ:

1. Mlɔ anyi ɖe dzidzenu 30 va ɖo 45 dzi le zã 3 va ɖo 5 gbãtɔwo me: Zã akɔtaɖonu eve alo etɔ̃ alo wedge cushion (alo mlɔ zikpui si dzi woate ŋu abɔbɔ ɖo dzi) ale be ʋukawo ƒe nyaƒoɖeamenu le thyroid aba me nanɔ sue le zã bliboa me eye amekoko megbe lãkusi ƒe vuvu naɖiɖi ayi anyime ayi dzia gbɔ.
2. Xɔ mɔ ɖe ʋuʋudedi, ʋuʋudedi, kɔdzi, kple teteɖeanyi nu aleke kee wòɖale o: Dzodzo ƒuƒu sesẽ zi ɖeka tso opioid vevesesetikewo alo teteɖeanyi le nugododeƒe dzi naa jugular venous pressure dzina ɖe edzi wu 60 va ɖo 80 mmHg eye ate ŋu atso ka aɖe le anterior thyroid vein alo superior thyroid artery ŋu. No atike siwo woŋlɔ na wò be woatsɔ atsi aɖuɖɔtoedɔ nu (ondansetron) enumake ne èdze aɖuɖɔ zi gbãtɔ la, zã aɖuɖɔtoe siwo fa tsɔ wu be nànɔ tetem ɖe eŋu, eye nàƒo asa na nu kpekpe siwo wu kilogram 4.5 (pound 10) kɔkɔ alo ta bɔbɔ ɖe akɔta te.
3. Na akaɖi kple lãgbalẽŋudɔwɔnu nanɔ afisi wò abɔ ate ŋu aɖo, eye mègadɔ alɔ̃ wò ɖeka le zã gbãtɔ me gbeɖe o: Ele be dɔnɔ ɖesiaɖe si wowɔ dɔ na le kɔdzi si wowɔa dɔ na le ʋumenugbagbeviɣidɔ me alo ame tsitsi si tsɔa agbanɔamedziwo la nanɔ ŋudzɔ ahalé ŋku ɖe wo ŋu le gaƒoƒo 24 gbãtɔ siwo wowɔ le amekokoa megbe. Na kɔmewu si le gota la nadze (menye ɖe woɖii ɖe awudziwui alo aɖabɛwu siwo ƒe kɔme le kɔkɔe te o) ale be woakpɔ do si le ŋɔti ƒe gɔme si bu le mɔ si menya kpɔna dzea sii bɔbɔe o la enumake.
4. No calcium kple vitamin D (calcitriol) si woɖo ɖi na nu me ɖe game dzi ne woŋlɔe na wò: Mègalala be wò nuyiwo alo asibidɛwo naʋuʋu hafi ano calcium carbonate tablets le thyroidectomy megbe o; serum calcium léle ɖe te xea mɔ na gbeɖiɖi ƒe ʋuʋu kpata si me hypocalcemic le.

Nutome ƒe xexlẽdzesi siwo ku ɖe nudzɔdzɔ kpatawo ŋu kple dɔwɔƒea ƒe ɖoɖowo¶

• United States kple Canada: Ƒo ka na 911. Amerikatɔwo ƒe Thyroid Habɔbɔ (ATA) Nyatakaka si ku ɖe Outpatient Thyroidectomy ŋu kple Amerika Ta kple Kɔ Habɔbɔ (AHNS) de se be dɔnɔ siwo woɖe asi le le thyroid alo parathyroid dɔwɔwɔ vɔ megbe la naxɔ mɔfiame kpata siwo woŋlɔ be woayi dɔwɔƒe si te ɖe wo ŋu kpata enumake hena kɔ ƒe vuvu, nuɖuɖu ƒe vevesese, alo gbe/gbɔgbɔ ƒe tɔtrɔ ɖesiaɖe, afisi atikewɔla siwo kplɔa wo ɖo kpata abadzivɔ ƒe decompression protocols do ŋgɔ na yaƒoƒomɔ̃ sesẽ.
• United Kingdom: Ƒo ka na 999. Yameʋuɖoɖo Sesẽ Habɔbɔ (DAS), Britaintɔwo ƒe Lãmetsiŋusẽ Kple Lãmetsiŋutinunyalawo ƒe Habɔbɔ (BAETS), kple ENT UK Mɔfiame Vovovowo na Ʋu si dona le Lãmetsiŋusẽdɔléle Megbe ƒe Dɔwɔnawo Dzikpɔkpɔ ɖo DESATS ƒe dzesidede ƒe ɖaseɖigbalẽ kple SCOOP (Ŋutilã ƒe ʋuʋu, Lã ŋutigbalẽ ƒe aŋenuwo, Ʋuʋu lãmeka ƒe ƒuƒoƒo, Ʋuʋu/ɖe ʋu si me ʋu sina tona, Pack wound) ƒe ɖoɖo nu. abadzivɔwo xɔname ƒe ɖoɖo si nu wowɔa dɔ le le NHS kɔdziwo katã me.
• Europa Dukɔwo ƒe Habɔbɔ: Ƒo ka na 112. Europa ƒe Dɔlékuiwutikewo ƒe Habɔbɔ (ESES) kple Europa Habɔbɔ si Kpɔa Atikewɔwɔ ƒe Dɔlélewo Kple Belélename Veviwo Gbɔ (ESAIC) ƒe mɔfiamewo bia be woanɔ tsitrenu enumake, woaɖe suture/clip ɖa to platysma kple strap lãmekawo siaa dzi hafi woade atike si naa alɔ̃dɔdɔ ame le kɔ ƒe ʋumenugbagbeviɣi siwo xea mɔ na ame me, kple yaƒoƒomɔ̃ si le kɔ ƒe ŋgɔgbe (cricothyroidotomy) dzadzraɖoɖi.
• Australia kple New Zealand: Ƒo ka na 000 le Australia alo 111 le New Zealand. Australia kple New Zealand Dɔlékuiwo ƒe Amekolawo (ANZES) kple ANZCA ƒe mɔfiamewo fiaa mɔ abi si woaʋu enumake le aba dzi hena yaƒoƒomɔ̃ ƒe nugbegblẽ le thyroideɖeɖe vɔ megbe.
• India kple Asia-Pacific: Ƒo ka na 112 le India, 995 le Singapore, 119 le Japan kple South Korea, alo 999 le Malaysia kple Hong Kong. Le dukɔ bubuwo gome la, kpɔ míaƒe nyatakakadzraɖoƒe si nye dukɔwo dome xexlẽdzesi siwo ku ɖe nudzɔdzɔ kpatawo ŋu.

Nya siwo wobiaa amewo enuenu¶

Ne nye amekoko ƒe kɔ ƒe tsidzɔƒe ƒuƒlu eye gotagome aŋe si wotsɔ blae la le dzadzɛ eye wòƒu la, ɖe nye kɔ me ʋu si me afɔku le ate ŋu anɔ ŋunye kokokoa?¶

Ɛ̃. Le ʋumenugbagbeviɣidɔ siwo ate ŋu ade ame ƒe agbe afɔku me le ʋumenugbagbeviɣidɔ ɖeɖeɖa megbe ƒe akpa gãtɔ me la, gotagome aŋe si wotsɔ blae la le dzadzɛ keŋkeŋ eye ʋu ʋɛ aɖewo koe nɔa plastik-nuɖemɔ̃a me. Ne ʋukawo alo ʋukawo me ʋu ƒo ƒu ɖe teƒe si xaxa si ƒo xlã yaƒoƒomɔ̃a me la, eƒona ɖe ʋuka si me ʋuʋudedi le me le aɖabaƒoƒo ʋɛ aɖewo ko me, eye wòxea do suesuesue siwo le plastik ƒe tsidzɔƒea me ale be naneke megagena ɖe gotagome akaɖia me o. Tsɔ alesi dɔnɔa ƒe kɔ sena le eɖokui me kple alesi womia nu hegbɔa yae drɔ̃a ʋɔnu kpata la ɣesiaɣi, eye mègatsɔe akpɔe ɖa be tsidzɔƒea le yɔyɔm hã o.

Nukatae ne woʋu aŋe siwo le kɔa ŋu la, ekpena ɖe ame ŋu wògbɔa ya ne ʋua le yaƒoƒomɔ̃a godo?¶

Lãmetsiŋusẽ ƒe lãkusi nɔa kotoku si me lãmekawo le sesẽ aɖe me le yaƒoƒomɔ̃a tame tututu, eye kɔ ƒe lãmeka siwo le tsitrenu (lãmeka siwo wotsɔ blaa ka) siwo wotsɔ lãfu blae kple vidzidɔ ƒe lãkusi sesẽwo xea mɔ nɛ. Ne ʋu yɔ kotoku ma si wotu nu ɖo la, nyaƒoɖeamenu dzina ɖe edzi ale gbegbe be wòmia yaƒoƒomɔ̃a ƒe megbegli falɛfalɛa ɖe eme eye wòmiãa ʋuka siwo me tsi tona le gbeɖiɖikawo me, si wɔnɛ be ŋɔti ƒe eme vuvu. Ne wotso ŋutigbalẽa ƒe ʋuʋudediwo kple lãmeka siwo le ete siaa la, eɖea nutsyɔnu la ɖa le xɔ ma si me nyaƒoɖeamenu le la ŋu, si wɔnɛ be ʋu si le dodom la te ŋu kɔna yia gota eye enumake ʋukawo me tsi kple yaƒoƒomɔ̃wo gaʋuna.

Nukatae zi geɖe la, aɖuɖɔ mimi sesẽ nyea kɔ me ʋu ƒe sisi ƒe dzesi gbãtɔ kekeake le thyroid alo akɔta ƒe dɔwɔwɔ vɔ megbe?¶

Nuɖuɖutome nye mɔ̃ falɛfalɛ si me lãmekawo te ŋu gbãna, si nɔa yaƒoƒomɔ̃a megbe tẽ eye wòtsia kɔ ƒe ƒu sesẽwo ŋu. Ne ʋu dze ƒoƒo ɖe kɔ ƒe akpa gogloawo me le thyroidectomy alo ŋgɔgbe vidzidɔ ƒe akɔta ƒe dɔwɔwɔ vɔ megbe la, etsia nuɖuɖutome falɛfalɛa nu ɣeyiɣi didi aɖe hafi nyaƒoɖeamenua va lolo ale gbegbe be wòate ŋu abla yaƒoƒoa ƒe ƒunukpeƒe ƒe asigɛ siwo sesẽ wu. Dɔnɔ si sea ƒu kplakplakpla zi ɖeka ne ele aɖuɖɔ mimi alo dze aɖuɖɔ dodo gɔme la hiã be woadoe kpɔ le kɔdzi enumake hafi gbɔgbɔtsixe nadze egɔme.

Nukae hea nuyiwo ƒe ʋuʋu kple "asiwo" ƒe ʋuʋu vɛ ŋkeke ɖeka alo eve le lãkusi ƒe dɔwɔwɔ vɔ megbe?¶

Lãmetsi sue ene siwo lolo abe bliku ene siwo woyɔna be parathyroid glands nɔa lãkusia megbe tẽ eye wokpɔa calcium ƒe agbɔsɔsɔ si tututu le wò ʋukawo me dzi. Le thyroidectomy bliboa me la, woate ŋu agbã lãkusi siawo siwo le bɔbɔe, woƒe ʋu natsi wo ŋu hena ɣeyiɣi aɖe, alo woaɖe wo le manyamanya me. Le gaƒoƒo 12 va ɖo 72 siwo kplɔe ɖo me la, ʋu me calcium dzi ɖena kpɔtɔna (hypocalcemia), si wɔnɛ be lãmekawo kple lãmekawo nɔa dzo dam le wo ɖokui si - edzea egɔme tso nu me kple asibidɛwo ƒe ʋuʋu kple ʋuʋu le nu me kple asibidɛwo ƒe nugbɔ dzi, wòyia ŋgɔ va ɖoa asiwo ƒe ʋuʋu sesĩe (tetany), eye ate ŋu ana gbeɖiɖika ƒe ʋuʋu si me afɔku le (laryngospasm) alo dzi ƒe ʋuʋu ƒe tɔtrɔ.

Ðe wòsɔ be gbe naɖi vie alo ɖeɖi nate ame ŋu le thyroid alo kɔ ƒe ŋgɔgbe ƒe akɔta ƒe dɔwɔwɔ vɔ megbea?¶

Gbe ƒe ɖeɖiteameŋu fafɛ, ŋɔti si le ʋuʋum vie tso gbɔgbɔtsixe si wozãna le alɔ̃dɔdɔ me, alo gbeɖiɖi fafɛ si li ke tso lãkusi ƒe lãmeka siwo gbugbɔna siwo vuvu gbɔ bɔ eye menye agbe ƒe afɔku o ne gbɔgbɔ kple nu mimi medze agbagba kura o eye kɔa le gbadzaa eye wòfa. Gake gbeɖiɖi ɖesiaɖe si le sesẽm ɖe edzi kabakaba, si kpe ɖe kɔ ƒe vuvu, aɖuɖɔ mimi sesẽ, alo ɣlidodo sesĩe ne wole gbɔgbɔm (stridor) ŋu la nye atikewɔwɔ kpata.

Dzɔtsoƒewo kple dziɖuɖumegãwo ƒe mɔfiame¶

• Difficult Airway Society (DAS), Britain Association of Endocrine and Thyroid Surgeons (BAETS), & ENT UK (United Kingdom): Mɔfiame vovovowo na ʋu si dona le ʋumenugbagbeviɣidɔ megbe la dzi kpɔkpɔ (Iliff HA et al., Anaesthesia, 2022: DESATS ƒe dzesidede dzidzenuwo kple SCOOP bedside wound evacuation protocol).
• Amerikatɔwo ƒe Thyroid Habɔbɔ (ATA, United States): Nyatakaka tso Dɔnɔwo ƒe Thyroidectomy ŋu: Mɔxexe Ðe Dɔwɔwɔ Megbe ƒe Vidzidɔ me Ʋusɔgbɔdɔ kple Hypocalcemia ƒe Mɔxexe Ðe Enu, Edzesi, Kple Edzikpɔkpɔ (Terris DJ et al., Thyroid).
• Amerikatɔwo ƒe Dɔlékuiwo ƒe Amekolawo ƒe Habɔbɔ (AAES, United States): Mɔfiamewo na Amekoko ƒe Dɔléle si Kpɔa Thyroid Dɔléle Dzi Le Ame Tsitsiwo Me Kpata (Patel KN et al., Anals of Surgery: pathophysiology of venous laryngeal edema, drain unreliability, and bedside strap-muscle opening).
• Society for Vascular Surgery (SVS) & European Society for Vascular Surgery (ESVS): Dɔwɔƒe ƒe Mɔfiamewo le Atherosclerotic Carotid kple Vertebral Artery Disease Dzikpɔkpɔ ŋu (Carotid endarterectomy megbe ʋukawo ƒe ʋusɔgbɔdɔ kple yaƒoƒomɔ̃wo ƒe tete dzi kpɔkpɔ).
• Anyiehe Amerika ƒe Akɔta Habɔbɔ (NASS) & Vidzidɔ ƒe Akɔta Ŋuti Numekuku Habɔbɔ (CSRS): Ya ƒe Mɔxenu Sesẽ Kple Retropharyngeal Hematoma Dzikpɔkpɔ le Anterior Cervical Spine Surgery (ACDF) megbe.

Mɔfiame siwo do ƒome kplii¶

• Epiglottitis, croup, stridor, kple yaƒoƒomɔ̃ si le etame ƒe xexe kpata
• Ʋu si dona le tonsillectomy megbe, eschar slough ʋu si dona le ame ŋu ŋkeke 5 va ɖo 10, kple yaƒoƒomɔ̃wo ƒe vovototodedeameme
• Ludwig ƒe angina, aɖu ƒe aɖuɖɔtoe ƒe yaƒoƒomɔ̃ ƒe vuvu, kple aɖuɖɔtoe te dɔlékui
• Thyroid ahom kple myxedema coma lãmenugbagbeviwo ƒe nɔnɔme kpatawo
• Ʋusɔgbɔdɔ ƒe dzesidede kple nuwɔwɔ kpata