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Airway Obstruction Caused by Substernal Thyrotoxic Multinodular Goiter
Haruihiro Sato1, Ryota Masuda, Masayuki Iwazaki
1Department of Medicine, Kanagawa Dental University Graduate School, 82 Inaoka-cho, Yokosuka, Kanagawa 238-8580, Japan. h.sato@kdu.ac.jp.
The Tokai Journal of Experimental and Clinical Medicine
|December 19, 2016
Summary
Substernal thyrotoxic multinodular goiter (MNG) can rarely cause acute airway obstruction. Careful monitoring is essential for patients with substernal thyrotoxic MNG to prevent severe respiratory distress.
Area of Science:
- Endocrinology
- Thoracic Surgery
Background:
- Substernal thyrotoxic multinodular goiter (MNG) presents with compressive symptoms and thyrotoxicosis.
- Acute airway obstruction is an uncommon complication of substernal MNG.
Observation:
- A 56-year-old woman with substernal thyrotoxic MNG, treated medically for six years, presented with acute dyspnea and inspiratory stridor.
- The patient's airway obstruction was attributed to the substernal MNG compressing the airway.
Findings:
- Medical management with methimazole maintained normal thyroid function for six years.
- Prompt airway intubation and subtotal thyroidectomy successfully resolved the airway obstruction and improved the patient's condition.
Implications:
- This case highlights the critical need for vigilant monitoring of substernal thyrotoxic MNG.
- Even with medical management, substernal MNG poses a risk of acute airway compromise, necessitating careful follow-up.
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