Goiter is an abnormally enlarged thyroid gland. It was once a common condition in the United States due to iodine deficiency, but the increased use of iodized salt has virtually eradicated this problem. Goiter cases today are most often a result of the coalescence of benign thyroid nodules, which can grow and sometimes multiply over time. Goiter tends to occur randomly, but it can also be associated with some medications and/or with other thyroid conditions. If the goiter extends from the neck into the upper chest, it is termed a substernal goiter.
Goiter remains an issue in many third world countries. Members of the Division of Thyroid and Parathyroid Surgery provide goiter surgery annually in an underserved area of Kenya, where they not only care for patients but also train local physicians to work toward sustainable health care for patients suffering from goiter in this region. Learn more about global health initiatives in the Division.
Patients with goiter may notice a visible, cosmetic distortion of the neck, the sensation of a lump in the throat when swallowing and/or actual difficulty swallowing. They may also have difficulty breathing due to compression of the windpipe.
It is important to assess the function of the thyroid gland in patients with goiter through comprehensive blood testing, as sometimes goiter can represent hyperthyroidism or Graves’ disease. In addition to blood testing and an appropriate physical examination of the thyroid, voice box and neck, the thyroid surgeon must assess the exact degree of enlargement of the thyroid and its impact on the neck and upper chest structures. This is often accomplished through ultrasonographic evaluation and CT scanning of the neck and upper chest.
Patients with goiter are evaluated by the Radiology Department at Mass. Eye and Ear, which has extensive experience with radiographic evaluation of the thyroid gland, the neck and structures in the chest. The radiologist and thyroid surgeon work together to determine the best course of action based on these evaluations.