Anesthesia management in thyroid surgery.

PURPOSE OF REVIEW: Thyroid surgery presents unique anesthetic challenges because of the anatomical proximity of the thyroid gland to the airway and critical neurovascular structures. This review highlights the importance of a structured and individualized perioperative approach in the context of increasing surgical volumes and evolving techniques.

RECENT FINDINGS: Preoperative assessment must be meticulous and multileveled, particularly in patients with goiter, tracheal deviation, or obesity. Risk stratification can be improved through advanced tools such as nasendoscopy, airway ultrasound, and neck circumference-to-thyromental distance ratio. Intraoperative management requires careful airway planning, optimized patient positioning, intraoperative nerve monitoring, and hemodynamic stability. Videolaryngoscopy is increasingly favored for its improved visualization and facilitation of electromyographic tube placement. Postoperative complications such as hematoma, tracheomalacia, and hypocalcemia demand structured monitoring. Artificial intelligence shows promise in enhancing prediction and decision-making in airway management.

SUMMARY: A context-sensitive, multidisciplinary approach across all perioperative phases is essential to improve safety and outcomes in thyroid surgery. Emphasis on airway assessment, vigilant intraoperative monitoring, and proactive postoperative care should guide clinical practice and future research.