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Bilateral recurrent nerve paralysis associated with multinodular substernal goiter: a case report
J W Souza1, J T Williams, M M Ayoub
1Department of Surgery, Mercer University School of Medicine, The Medical Center of Central Georgia, Macon, USA.
The American Surgeon
|May 7, 1999
Summary
Substernal goiters rarely cause bilateral recurrent laryngeal nerve palsy. This case highlights a rare complication in an elderly patient presenting with respiratory distress due to a multinodular substernal goiter.
Area of Science:
- Otorhinolaryngology
- Endocrinology
- Thoracic Surgery
Background:
- Substernal goiters are uncommon, occurring in 2-5% of thyroid surgery patients.
- They can compress airway structures, leading to respiratory and vocal symptoms.
- Unilateral recurrent nerve palsy is a rare but documented complication.
Observation:
- A case of an 89-year-old female with a multinodular substernal goiter is presented.
- The patient experienced significant respiratory distress.
- Bilateral recurrent laryngeal nerve palsy was diagnosed.
Findings:
- The substernal goiter was identified as the cause of bilateral recurrent nerve palsy.
- This association is highly infrequent, with only a few cases reported in medical literature.
- The patient's respiratory distress was directly linked to the nerve palsy.
Implications:
- This case underscores the importance of considering substernal goiter in the differential diagnosis of bilateral vocal cord paralysis.
- It highlights a rare but severe complication that can arise from substernal thyroid masses.
- Prompt diagnosis and management are crucial for improving patient outcomes in such rare presentations.