Special Sono-Case: A focused thyroid and neck ultrasound examination in a patient with altered airway anatomy after laryngectomy or tracheostomy.

Why this case matters

A permanent stoma or tracheostomy changes the usual neck landmarks and introduces air, scar tissue, surgical clips, and limited transducer access. These factors may obscure thyroid tissue and central-neck structures unless the examination is deliberately adapted.

The case covers

• Pre-scan review of the operative history and airway anatomy
• Safe transducer positioning around the stoma and dressings
• Recognition of air-related reverberation, scar, clips, and distortion
• Assessment of residual thyroid tissue, nodules, lymph nodes, and postoperative complications
• Doppler optimization, reporting language, pitfalls, and ARDMS-style questions

Educational material only. This fictional, deidentified case does not replace local protocol, radiologist interpretation, or individualized medical care.

Dr. Godefroy A. Watchiba, MD, RDMS, RVT