- Design
- Retrospective single-centre cohort
- Population
- 214 patients referred for thyroid compressive symptoms, 2015 to 2025
- Primary outcome
- Symptom improvement and alternative diagnoses
- Effect
- 83% improved after surgery (91% with orthopnoea); reflux 36% and muscle tension 23% among non-operated
This single-centre series reviewed 214 patients referred between 2015 and 2025 with symptoms attributed to compression from thyroid nodules, goitre or cysts.
Surgery was performed in 82 (38%), and 83% of them improved. Operated patients had much larger nodules (median volume 36.4 vs 6.4 cm³). Breathlessness and orthopnoea were associated with being recommended surgery, and orthopnoea had the highest resolution rate after surgery (91%). Among the 110 not recommended surgery, globus and dysphagia were the commonest complaints, and reflux (36%) and laryngeal muscle tension (23%) were the commonest alternative diagnoses.
This gives ENT surgeons and GPs a practical filter: large nodules with breathlessness or orthopnoea do well with surgery, while globus with a small nodule often has another cause. It is retrospective and single-centre, and the surgical group was selected, so the improvement rate reflects careful selection rather than what any patient can expect.
- Offer surgery for compressive symptoms mainly when nodules are large and symptoms include breathlessness or orthopnoea.
- Treat reflux or refer for voice therapy when globus or dysphagia accompanies a small nodule.
- Tell patients with orthopnoea and a large goitre that most improve after thyroidectomy.
- Re-evaluate the thyroid if symptoms persist after reflux and muscle tension have been addressed.
Why it matters
It helps avoid thyroid surgery that will not relieve symptoms caused by something else.
Don't overread it
Retrospective single-centre series; the 83% improvement applies to selected patients.
The statistics, in plain English
The 83% and 91% figures are simple proportions among operated patients, not comparisons with a non-operated group, so they show outcome after selection rather than the effect of surgery.
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