Toxic Multinodular Goitre	

The goitre may extend retrosternally and cause stridor, by compression of the trachea (Fig. 17.58), or dysphagia from oesophageal narrowing. When a large unilateral nodule is present, the displaced trachea may be mistaken for the other lobe of the thyroid which is erroneously believed to be diffusely enlarged. 
The majority of apparently unilateral nodules are found at operation to be the largest nodules in a multinodular gland. The nodularity of a goitre is more easily demonstrated by ultrasound rather than by the patchy uptake on radioisotope scan.