DYSPNEA FOLLOWING THYROID OPERATIONS

The mortality in thyroid operations during the last fifty years has decreased so extensively that in nontoxic goiters it is almost negligible, while in the toxic types it is only from 2 to 5 per cent. Various factors have brought about these reductions. Owing to the invention of the artery clamp by Paeon¹ and the researches of Streckeisen² and Kocher³ on the blood supply of the thyroid gland, hemorrhage has been removed as the prime cause of death. Rose⁴ called attention to the importance of tracheal compression, and the possibility of asphyxia due to tracheal obstruction. The rôle of recurrent laryngeal nerve injury as a possible contributory cause of death was emphasized by Seitz.⁵ Today, the earlier operation, the better preoperative preparation, the use of gas and oxygen and of local anesthesia, the improved operative technic and the important changes in after-treatment have aided greatly