The novel use of coblation whilst undertaking a challenging tracheostomy in a patient with anaplastic thyroid cancer

Introduction: Coblation is a relatively new technique where tissue is ablated using radiofrequency energy. It has increasing applications in benign and malignant head and neck tumours. Case report: We present the case of a 63-year-old man with an anaplastic spindle cell thyroid carcinoma, presenting to the on-call ENT team with acute stridor. A recent MRI scan showed a 7 cm mass invading through the lateral wall of the trachea and extending superiorly into the supraglottic larynx. The history suggested previous radiotherapy treatment. A tracheostomy under local anaesthesia was performed. The tumour was large, hard and displacing the trachea and therefore coblation was utilised for this challenging case. Conclusion: The use of coblation was valuable in this setting as it allowed tumour debulking with haemostatic control over the thyroid cartilage and trachea. We report the first case, as far as we are aware, of the use of coblation in a surgical tracheostomy. Correspondence to: Ramkishan Balakumar, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK; Email: [email protected]