Multinodular thyroid goitre causing obstructive sleep apnoea syndrome.
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.


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.


CONCLUSIONS
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.
Department of Otorhinolaryngology and Head and Neck Surgery, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK.
T
T
Gutierrez
A C
AC
Leong
L
L
Pang
E
E
Chevretton
J-P
JP
Jeannon
R
R
Simo
D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D015992:Body Mass Index; D045422:Continuous Positive Airway Pressure; D004724:Endoscopy; D005260:Female; D006044:Goiter, Nodular / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D006801:Humans; D007819:Laryngeal Edema / Q000150:complications* / Q000175:diagnosis; D008875:Middle Aged; D017286:Polysomnography; D012189:Retrospective Studies; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D013965:Thyroidectomy; D014057:Tomography, X-Ray Computed; D014132:Trachea / Q000473:pathology / Q000601:surgery