The term "goiter" refers to a swelling or abnormal enlargement of the thyroid gland. A goiter may be caused by several things. Worldwide the most common cause is iodine deficiency, most prevalent among populations who do not have access to seafood. In the U.S., widespread access to seafood, along with iodized salt, makes iodine deficiency quite uncommon. Other causes of goiter include Graves' disease and thyroiditis. However many patients have an abnormal thyroid enlargement that is not attributable to one of these causes. This is most commonly due to multinodular goiter, or just "goiter" for short.
Multinodular goiter is characterized by numerous nodules and cystic areas within the thyroid gland. This results in an enlarged gland that can cause symptoms because of the size. Occasionally it may function to produce excess thyroid hormone, but more commonly thyroid hormone production is normal. The large size and firmness of the gland may cause difficulty in swallowing or a sense of "choking". It may cause airway obstruction, most commonly when in certain positions such as when lying on the back or looking up. It may also produce a visible swelling in the neck that may become unsightly.
Many patients with multinodular goiter are unaware of the problem, and do not require any treatment. Indications for treatment include difficulty swallowing, airway compromise, cosmetic deformity, or hyperthyroidism.
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If you have questions you may contact us at Endocrine_Surgery@med.unc.edu