Upper airway obstruction in euthyroid goiter
R. Jauregui, E. S. Lilker and A. Bayley
Although it is recognized that an enlarged thyroid may occasionally cause
tracheal compression, the incidence in euthyroid goiter is unknown. Twenty
patients with nontoxic goiter were investigated for upper airway
obstruction. Although none of them had dyspnea as a chief complaint, on
direct questioning 9/20 had a history of shortness of breath on exertion
and choking sensation. Upper airway obstruction was detected in 7/20 (35%)
by roentgenography, 12/20 (60%) by flow volume loop (FVL), and in 16/20
(80%) by combined roentgenography and FVL. After therapy for goiter, there
was a reduction in the size of the goiter and an improvement in FVL in the
whole group. The statistically significant change occurred in peak
expiratory flow (P less than .01) and peak inspiratory flow (P less than
.05). These findings and the change in configuration of the curve suggested
less upper airway compression. We conclude that goiter often causes
unsuspected upper airway obstruction, usually slow in onset and not noticed
by the patient.
