Extreme tracheal compression due to substernal goiter: Surgical and anesthetic management

Substernal goiters can have a range of presentations and pathology from a complete lack of symptoms to minimal biochemical abnormalities to potentially lethal physical derangements due to tracheal compression. We review a case of a substernal goiter with severe tracheal compression and airway compromise and describe the presentation, diagnosis, operative treatment, perianesthetic management and outcome of this patient. Substernal goiters can have a myriad of symptoms and etiologies. Once the diagnosis is secured, a multidisciplinary approach is key to successful management in the perioperative period.