Bilateral recurrent nerve paralysis associated with multinodular substernal goiter: A case report

Substernal goiter is an infrequent occurrence and is found in two to five p er cent of all patients undergoing thyroid surgery. These lesions are well known to cause respiratory symptoms and alterations in phonation due to dir ect compression of airway structures. Infrequently, unilateral recurrent ne rve palsy has been reported in patients with substernal goiter. We report a case of bilateral recurrent nerve palsy associated with multinodular subst ernal goiter in an 89-year-old female who presented in respiratory distress .