Clinical Characteristics and Predictors Related to the Progression of Multinodular Goiter Causing Tracheal Compression and Deviation: A Report of Two Cases and Review of the Literature

Abstract

We describe the clinical course of two patients who developed tracheal compression and deviation by multinodular goiter (MNG). Case 1: A 66-year-old woman presented with thyroid swelling. Five years after the initial admission, she was diagnosed with hyperthyroidism by Graves' disease and increased bilateral thyroid lobes compressing the trachea. Thyroglobulin was elevated from 210 to 472 ng/mL. Case 2: A 52-yearold woman presented with thyroid swelling. Five years after the initial admission, the increased right lobe deviated the trachea and compressed the right recurrent laryngeal nerve. Thyroglobulin was elevated from 122 to 392 ng/mL. Two cases and literature review indicated that MNG with >50 mm, solid components, and extension to the mediastinum or paralarynx were risk factors of tracheal compression and deviation. Monitoring thyroglobulin elevation can help predict the clinical course.

Extracorporeal membrane oxygenation for thyroid surgery in patients with severe tracheal stenosis

“…Severe tracheal stenosis is relatively rare, and the most common cause is thyroid gland enlargement. 8 It is inadvisable for an anesthetist to insert an endotracheal tube, as careless induction of anesthesia may result in failure in intubation, further hypoxemia, and even respiratory or cardiac arrest due to airway obstruction. 5 Under these circumstances, ECMO emerges as a reliable alternative for treatment.…”