Management of a deaf and mute patient with large multinodular goiter posted for thyroidectomy can be a challenge for the operating team. Building a good rapport with the patient and ensuring closed– loop conversations with regards to operative steps and possible complications of surgery as well as anaesthesia aids in reducing patient‘s anxiety and insecurities. Co–ordinated team efforts of Otorhinolaryngologists and Anaesthesiologists can be help in smooth conduct of surgery and faster recovery.