Place of tracheal configuration in the radiological assessment of goitres

In a study of 160 unselected patients with goitre, 116 (72.5%) had tracheal deviation and ninety-two (57.5%) had tracheal narrowing. Tracheal deviation to the right constituted 65% of the lateral deviations, but when thyroid malignancies only were considered, a disproportionately large number (ten of the thirteen cases) showed deviation to the left. Anterior deviation and irregular tracheal narrowing which were previously considered to be characteristic of thyroid malignancy are shown to be non-specific. Whereas irregular tracheal narrowing should still raise the suspicion of malignancy, a simple multinodular goitre may produce a similar appearance, resulting from variable degrees of pressure on the trachea by adjacent thyroid nodules of different sizes.