A large thyroid goiter may compress adjacent structures, especially if there is substernal extension. A severe compression syndrome is an indication for surgical resection of the goiter.
Anatomical structures that may be compressed or compromised:
(1) trachea
(2) esophagus
(3) nerves
(4) veins
(5) arteries
(6) other structures
|
Tracheal Compression |
Complications |
|
tracheal obstruction |
chronic nonproductive cough, hoarseness, dyspnea, stridor, respiratory distress, asphyxia, tracheomalacia, right sided heart failure (secondary to hypoxia) |
Obstruction of the trachea and veins at the thoracic inlet is Pemberton's syndrome (see above).
|
Esophageal Compression |
Complications |
|
esophageal compression |
dysphagia |
|
paraesophageal venous compression |
esophageal varices with acute upper GI hemorrhage |
|
Nerve Compression |
Complications |
|
left recurrent laryngeal nerve |
vocal cord palsy |
|
phrenic nerve |
paralysis of diaphragm, respiratory failure if bilateral |
|
superior cervical ganglion |
Horner's syndrome |
|
Venous Compression |
Complications |
|
superior vena cava |
superior vena cava syndrome, portal hypertension |
|
venous thrombosis |
|
|
pulmonary veins |
pleural effusions |
|
Arterial Compromise |
Complications |
|
carotid or vertebral artery (compression or thyrocervical steal) |
transient ischemia or stroke |
|
pulmonary arteries |
pulmonary hypoperfusion |
|
Compression of Other Structures |
Complications |
|
thoracic duct |
chylothorax |
Specialty: Endocrinology, Clinical Laboratory
ICD-10: ,
