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Advanced upper airway obstruction caused by cervical goiter
M Chiriboga1, J Oropello, K Padmanabhan
1Department of Medicine, Coney Island Hospital, Brooklyn, NY 11235.
The American Journal of the Medical Sciences
|March 1, 1989
Summary
Large goiters can cause severe breathing problems even with few symptoms. Spirometry testing is recommended for patients with large goiters to detect potential airway obstruction.
Area of Science:
- Otolaryngology
- Pulmonology
- Endocrinology
Background:
- Goiters, or enlarged thyroid glands, are an uncommon cause of significant upper airway obstruction.
- Most previously reported cases involved substernal goiters and pronounced symptoms.
Observation:
- A patient presented with minimal respiratory symptoms but demonstrated severe upper airway obstruction due to a cervical goiter.
- Despite long-term thyroid hormone therapy, the patient's condition persisted.
Findings:
- The patient's spirometry results, including the flow-volume loop, indicated severe obstruction exceeding criteria for urgent surgical intervention.
- This case highlights a discrepancy between subjective symptoms and objective pulmonary function.
Implications:
- Patients with large goiters require spirometry with flow-volume loop assessment, regardless of apparent respiratory distress.
- Early detection of airway compromise in goiter patients is crucial for timely management and preventing severe complications.