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Tracheal or esophageal compression due to benign thyroid disease
American Journal of Surgery
|September 1, 1981
Summary
Benign goiters frequently cause tracheal or esophageal compression, especially in thyroiditis. Early surgery is recommended upon detecting tracheal deviation to prevent sudden airway occlusion.
Area of Science:
- Endocrinology
- Thoracic Surgery
- Diagnostic Imaging
Background:
- Benign goiters are common endocrine conditions.
- Tracheoesophageal compression can lead to significant morbidity.
- Understanding compression patterns is crucial for patient management.
Observation:
- 91 (33%) of 273 patients with benign goiter experienced tracheal or esophageal compression.
- Nodular colloid goiter (66%) was the most common cause, followed by adenoma (21%), thyroiditis (9%), and Graves' disease (4%).
- Thyroiditis presented with higher compression rates (67%) compared to colloid goiter (46%).
Findings:
- Two-thirds of patients with compression reported dyspnea or dysphagia.
- Tracheal deviation on radiography often preceded symptomatic presentation.
- Sudden tracheal occlusion occurred in 3% of cases, necessitating emergency intervention.
- Multinodular goiter and thyroiditis were associated with more frequent and severe compression.
- Compression predominantly affected the trachea over the esophagus.
Implications:
- A clinical spectrum of compression exists, from asymptomatic deviation to severe airway compromise.
- The onset of complete airway occlusion can be sudden and unpredictable.
- Proactive surgical intervention is advised upon radiographic evidence of tracheal deviation to mitigate risks.