Upper airway obstruction from a benign goiter

Acute upper tracheal obstruction from a huge benign goiter developed in an 80-year-old woman. Computed tomography showed severe stenosis of the cervical trachea by extrinsic compression. A left hemithyroidectomy was performed and the tracheal lumen returned to normal size. However, the tracheal wall was malacic due to the prolonged compression by the goiter and a silastic T-tube insertion was necessary for a two month period. This type of tracheal obstruction is rare.

The importance of evaluating the upper trachea in patients with prolonged benign goiter is stressed and the diagnosis as well as the management of this type of complication are discussed.