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Invited Critique
July 2012

“Doctor, My Thyroid Is Choking Me”Comment on “Positional Dyspneaand Tracheal Compression as Indications for Goiter Resection”

Author Affiliations

Author Affiliations: Department of Surgery, University of Wisconsin Medical School, Madison.

Arch Surg. 2012;147(7):626. doi:10.1001/archsurg.2012.236

Using a structured algorithm to evaluate respiratory symptoms in patients presenting for surgical treatment of thyroid disease, Stang and colleagues1 demonstrate that thyroidectomy ameliorates positional dyspnea and sleep apnea. Analysis of 197 patients with tracheal compression and/or positional dyspnea revealed that positional dyspnea improved in direct correlation to the resected gland weight. Those patients with obstructive sleep apnea experienced subjective improvement in snoring or dyspnea, but only a small number (3 patients) underwent postoperative polysomnography. Stang et al also observed a significant increase in the proportion of patients whose positional dyspnea improved when tracheal compression reached a threshold of at least 35%.

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