Which organ near the trachea is at risk of injury during a tracheotomy?

• A. Lungs
• B. Thyroid gland
• C. Esophagus
• D. Heart

Answer: (B)

When gaining access to the trachea from the front of the neck, the structures that lie directly over the trachea are the ones most at risk. The thyroid gland sits right in front of the trachea in the midline, with its isthmus crossing the trachea around the upper rings. Because the trachea is approached through the anterior neck, the thyroid gland can be injured or temporarily retracted during the procedure, making it the most likely organ to be at risk. The lungs are deeper in the chest, the esophagus lies behind the trachea, and the heart is well posterior to the trachea, so they’re less of a concern with the typical anterior neck approach.