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Multinodular thyroid goitre causing obstructive sleep apnoea syndrome

Published online by Cambridge University Press:  12 October 2011

T Gutierrez ,
A C Leong ,
L Pang ,
E Chevretton ,
J-P Jeannon  and
R Simo
T Gutierrez
Affiliation:
Department of Otorhinolaryngology and Head and Neck Surgery, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK
A C Leong
Affiliation:
Department of Otorhinolaryngology and Head and Neck Surgery, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK
L Pang
Affiliation:
Department of Otorhinolaryngology and Head and Neck Surgery, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK
E Chevretton
Affiliation:
Department of Otorhinolaryngology and Head and Neck Surgery, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK
J-P Jeannon
Affiliation:
Department of Otorhinolaryngology and Head and Neck Surgery, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK
R Simo*
Affiliation:
Department of Otorhinolaryngology and Head and Neck Surgery, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK
*
Address for correspondence: Mr Ricard Simo, Dept of Otorhinolaryngology and Head and Neck Surgery, 3rd Floor, Southwark Wing, Guy's and St Thomas' Hospital NHS Foundation Trust, St Thomas' Street, London SE1 9RT, UK Fax: + 44 (0)207 188 2206 E-mail: Ricard.simo@gstt.nhs.uk
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Abstract

Background:

Obstructive sleep apnoea syndrome has been linked to obesity, nasal obstruction and adenotonsillar hypertrophy, but rarely to large thyroid goitres.

Objective:

To study the possible association between multinodular retrolaryngo-pharyngeal or retrosternal goitres and obstructive sleep apnoea syndrome.

Subjects and methods:

Retrospective case series at a tertiary referral centre (2000–2010). Study parameters included body mass index, Epworth sleep score and polysomnographic index.

Results:

Five patients were diagnosed with obstructive sleep apnoea syndrome and managed with nasal continuous positive airway pressure ventilation. Computed tomography showed a retrolaryngo-pharyngeal or retrosternal goitre with significant tracheal compression, displacement and laryngeal oedema. After total thyroidectomy, obstructive sleep apnoea resolved in all patients.

Conclusion:

Large, multinodular goitres with retrolaryngo-pharyngeal extension can cause obstructive sleep apnoea syndrome due to laryngeal compression and oedema. In such cases, total thyroidectomy enables resolution of symptoms. Patients with obstructive sleep apnoea syndrome should be screened for thyroid goitre.

Keywords

GoitreThyroidectomyObstructive Sleep Apnoea Syndrome
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 2 , February 2012 , pp. 190 - 195
Copyright
Copyright © JLO (1984) Limited 2011

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Footnotes

Presented at the British Association of Thyroid and Endocrine Surgeons conference, 21–22 October 2010, Birmingham, UK

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