Assuming that patient has history of difficult airway management and/or goiter compression symptoms the case is indeed very challenging.
Although the sux approach seems straight forward, the airway can collapse and things could get a bit scary. My approach will be AP/lateral xrays of the neck, reassurance of the patient, titrated sedation (remi or dex might help), appropriate topicalization of nose and throat, awake FO intubation as per ASA algorithm. If not available, not enough expertise, go with other awake methods, including old reliable blind nasal awake. Place NG drainage catheter and suction then take it out. All sorts of gastric protection with ranetidine or omeprazol etc plus non particulate antacids.
Regards