Upper airways obstruction in 153 consecutive patients presenting with thyroid enlargement: Table 1

Thyroid enlargement affects up to 10% of the British population. Surgery is indicated for severe tracheal compression, and assessment of a respiratory flow volume loop is regarded as the best method for evaluating upper airways obstruction. Upper airways obstruction is considered rare in patients with goitre and indicated by symptoms such as breathlessness and choking. To investigate the prevalence of this problem we performed a prospective study of euthyroid patients presenting with nodular or diffuse thyroid enlargement, including those with and without symptoms suggesting tracheal compression. We studied 153 consecutive patients (134 female, 19 male) referred to our thyroid clinic because of thyroid enlargement. Clinical evaluation included completion of standardised questionnaires concerning breathlessness1 and goitre symptoms. Plain radiography of the thoracic inlet was performed and flow volume loops were recorded.2 Flow volume loops showed upper airways obstruction in 51 of 153 patients (33%). Forced vital capacity, forced expiratory volume in one second (FEV1), and peak expiratory flow (PEF) were expressed …