55 yr. old female patient presented with large toxic multinodular goiter with compression effect on breathing and swallowing due to retrosternal extension which proved by ultrasound examination of thyroid and CT scan of head and neck.
She was treated with anti thyroid drugs and became euthyroid.
Successful total thyroidectomy done with preserving parathyroid glands and intact bilateral recurrent laryngeal nerves.
Smooth postoperative course.