Key result
Thyroidectomy successfully decompressed the carotid sinus and airway, resolving bradycardic episodes and avoiding pacemaker implantation in a patient with a massive multinodular goiter.
Case Report (n=1)
Treating underlying reversible causes of symptomatic bradycardia, such as a massive goiter causing carotid sinus syndrome, can obviate the need for permanent pacemaker implantation.
Thyroidectomy may avoid pacing in select goiter patients with carotid sinus compression; leaves open confirmation in larger cohorts.
Sinus node dysfunction with symptomatic bradycardia or chronotropic incompetence is generally an indication for pacemaker implantation. However, in patients with symptomatic sinus bradycardia, the identification and treatment of underlying pathologies may avoid the need for permanent pacemaker implantation. We present a case of carotid sinus syndrome and severe obstructive sleep apnea due to a massive multinodular goiter in a patient who presented with recurrent sinus pauses and syncope. The patient was managed without pacemaker implantation but instead with thyroidectomy resulting in decompression of the carotid sinus and airway and resolution of bradycardic episodes.
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Deshmukh et al. (2017) conducted a case report in Carotid sinus syndrome and severe obstructive sleep apnea due to massive multinodular goiter (n=1). Thyroidectomy was evaluated on Resolution of bradycardic episodes. Thyroidectomy successfully decompressed the carotid sinus and airway, resolving bradycardic episodes and avoiding pacemaker implantation in a patient with a massive multinodular goiter.
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