The trachea was deviated.
The enlargement of the thyroid gland due to a multinodular goiter may not be symmetrical. In this case there was significant asymmetrical enlargement of the left lobe of the thyroid deviating the trachea to the right.
The patient had a hoarse voice and noisy breathing.
If the thyroid gland enlargement is significant it can compress the trachea, narrowing it to such an extent that a “crowing sound” is heard during inspiration (stridor).