Ricerc@Sapienza

Objectives/Hypothesis: During intraoperative neural monitoring (IONM) in thyroid and parathyroid surgery, endotracheal
(ET) tube migration can result in a decrease in vocalis electromyographic (EMG) amplitude without a concordant latency
elevation during stimulation of the recurrent laryngeal nerve (RLN).
Study Design: Retrospective review.
Methods: Data were reviewed retrospectively for thyroid and parathyroid surgery patients with IONM of the laryngeal

Background Acute respiratory failure is a rare life threatening complication following thyroid surgery and its incidence is reported as high as 0.9%. Clinical presentation of severe acute respiratory failure is characterized by dyspnea, inspiratory airways distress, hypoxia and its standard current management is the orotracheal intubation and safe extubation. In case of persistent distress, tracheotomy is mandatory. The Authors, analysing a large acute respiratory failure clinical series, describe an innovative treatment of this severe condition: the nasotracheal prolonged safe extubation.

SARS-Co-2 disease 2019 (COVID-19) has rapidly spread worldwide since December 2019. A relevant rate of patients develops an acute respiratory distress syndrome that require hospitalization. Among them, a non-negligible rate (9.8%-15.2%) requires tracheal intubation for invasive ventilation. We report the case of a COVID-19 patient developing pneumomediastinum and subcutaneous emphysema secondary to post-intubation tracheal injury. The management of COVID-19 patient can be challenging due to the risk of disease transmission to caregivers and epidemic spread.