Abstract
Objective: Expose the difficulty of preoperative and intraoperative conduction of a patient with difficult airway (VAD), due to large thyroid multinodular goiter and review the current protocols. As well as mention new equipments which can be used for efficient artificial ventilation. Case Details: This is a case report based on medical records analysis of a patient who underwent artificial ventilation during total thyroidectomy. This procedure took place in 2019, in a public hospital in a city in the interior of the state of São Paulo. The patient was an 85-year-old female, with a body mass index (BMI) of 19 kg/m2 and due to an anatomical thyroid alteration, she needed a thyroidectomy. Therefore, it is necessary to obtain a definitive airway before of the surgery, which can be considered a challenge, given the conformational changes existing in the anterior cervical region of the patient. Final considerations: Given the difficulty observed, it was necessary to obtain a definite airway with the patient awake. Choice which proved effective as soon as no complications occurred and recovery was also adequate.