Incidental Discovery of Tracheal Diverticulum During Thyroidectomy: A Report of Seven Cases.

Aim: Tracheal diverticulum, an air-filled sac typically located on the right posterolateral aspect of the trachea, has an unclear etiology. This study evaluates the clinical management and outcomes of incidentally detected tracheal diverticula in patients with papillary thyroid carcinoma, emphasizing the need for preoperative diagnosis and selective treatment.

Case presentation: Within our multi-center thyroid surgery cohort, seven cases of tracheal diverticula were incidentally discovered during thyroidectomy, with preoperative diagnosis achieved in only a subset of patients. Some tracheal diverticula were surgically excised, allowing for histopathological examination, whereas others were left in situ. All patients recovered without postoperative complications.

Results: Histopathological examination of the resected tracheal diverticula confirmed benign pathology. All patients, including those with untreated tracheal diverticula, remained asymptomatic during follow-up, with no tracheal abnormalities or complications observed. High-resolution computed tomography and three-dimensional reconstruction technology proved effective for the preoperative diagnosis of tracheal diverticulum.

Conclusions: Routine surgical treatment is unnecessary for asymptomatic patients, with resection of tracheal diverticulum reserved for symptomatic cases. Diagnostic approaches such as high-resolution computed tomography and three-dimensional reconstruction serve as essential preoperative assessments before thyroidectomy, enabling accurate diagnosis of tracheal diverticulum.