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  • Title: The surgical approach to retrosternal goiters: the role of computerized tomography.
    Author: Grainger J, Saravanappa N, D'Souza A, Wilcock D, Wilson PS.
    Journal: Otolaryngol Head Neck Surg; 2005 Jun; 132(6):849-51. PubMed ID: 15944553.
    Abstract:
    OBJECTIVE: To assess preoperative CT scans of patients with a retrosternal goiter, with an objective of identifying features that are likely to predict the need for sternotomy at operation. STUDY DESIGN AND SETTING: A retrospective review of clinical notes and CT scans of patients who underwent thyroidectomy for retrosternal goiter at a large district general hospital in the United Kingdom between 1998 and 2002. RESULTS: Extension of the goiter to the level of the aortic arch, particularly when combined with tracheal involvement or major vessel displacement, increases the likelihood of requiring median sternotomy. CONCLUSIONS: Most retrosternal goiters can be approached through a cervical incision alone. However, extension of the goiter to the level of the aortic arch does appear to increase the likelihood of requiring sternotomy. SIGNIFICANCE: In such cases in which sternotomy is anticipated, the availability of cardiothoracic services would be helpful to avoid patient morbidity.
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