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Treatment of obstructive or substernal goiter

Douglas S Ross, MD
Section Editor
David S Cooper, MD
Deputy Editor
Jean E Mulder, MD


Goiter refers to abnormal growth of the thyroid gland. Patients with longstanding goiters (cervical or substernal) may develop symptoms of obstruction due to progressive compression of the trachea or sudden enlargement (usually accompanied by pain) secondary to hemorrhage into a nodule. The most common obstructive symptom is exertional dyspnea, which is present in 30 to 60 percent of cases, and usually occurs when the tracheal diameter is under 8 mm. Substernal goiter may be detected incidentally on chest radiograph or computed tomography (CT) scan or found because of obstructive symptoms such as dyspnea, wheezing, or cough.

The treatment of obstructive and substernal goiters will be reviewed here. The clinical manifestations and evaluation of goiter and the management of benign nonobstructive goiter are reviewed separately.

(See "Clinical presentation and evaluation of goiter in adults", section on 'Goiter with obstructive symptoms or suspected substernal goiter'.)

(See "Treatment of nontoxic, nonobstructive goiter".)

(See "Treatment of toxic adenoma and toxic multinodular goiter".)

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Literature review current through: Nov 2017. | This topic last updated: Apr 18, 2017.
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