Cervico-mediastinal goiter: is telescopic exploration of the mediastinum (video mediastinoscopy) useful?☆

Costanzo, Mario; Cannizzaro, Matteo Angelo

doi:10.1510/icvts.2009.217638

Cited by 20 publications

(12 citation statements)

References 5 publications

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“…The use of the mediastinoscope [70] and more recently the use of video-assisted mediastinoscope (VAM) have been introduced in the management of the ITG [71]. VAM allows the dissection of the mediastinal component of the goitre from the main thoracic structures up to the level of the carina, main bronchus, pulmonary arteries and superior vena cava under direct video-assisted view.…”

Section: Minimally Invasive Approaches For the Intrathoracic Goitrementioning

confidence: 99%

Surgical management of intrathoracic goitres

Simó

Nixon

Poorten

et al. 2018

Eur Arch Otorhinolaryngol

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Background Intrathoracic goitres (ITG) often present with compressive symptoms and require specialised care by experienced surgical teams. Most ITG can be accessed by a transcervical approach (TCA) and only between 1 and 15% will require an extracervical approach (ECA). Many controversies exist regarding the clinical presentation, evaluation, selection of cases for ECA, surgical technique and outcomes. This paper reviews the recent literature on the management, outcomes and evidence-based treatment strategies of ITG. Methods We conducted a review of the literature on the evaluation, management and outcomes of surgery for ITGs. Results The incidence of cancer in the ITGs ranges between 4 and 20%. Multiplanar CT scanning offers the best preoperative evaluation and aids to determine the approach. Most ITG can be accessed by TCA and ECA are only needed in maximum 15% of cases. In experienced hands, the outcome of these surgeries is comparable to thyroid surgery for non-ITG. Conclusions Surgery for ITG is challenging. The experienced surgeon however, with few exceptions can address ITG via TCA, with outcomes comparable to those of uncomplicated thyroid surgery.

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Section: Minimally Invasive Approaches For the Intrathoracic Goitrementioning

confidence: 99%

Surgical management of intrathoracic goitres

Simó

Nixon

Poorten

et al. 2018

Eur Arch Otorhinolaryngol

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“…The maneuver involves 'elevating both arms until they touch the sides of the head'; if the sign is present 'after a minute or so, congestion of the face, cyanosis, and lastly distress become apparent [13]. We detected moving up of the MG toward to neck when the neck of the patient had extension due to increased intrathoracic pressure, so became apparent in our patient [14][15][16].…”

Section: Discussionmentioning

confidence: 77%

A Mediastinal Goitre Case That Moving Upward To Neck during a Cystoperitoneal Shunting Operation

Küçükyıldız¹

2018

BJSTR

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Arachnoids cysts (AC) are non-tumoral and congenital lesions and constitute 1% of all intracranial space occupying lesions [1]. Ninety percent of ACs is located in the supratentorial region and 10% are in the posterior fosse [2]. The middle cranial fosse is the most common place of the ACs (60%) other sites include seller region, cerebral convexity, and quadrigeminal plate. The clinical signs and symptoms of ACs are relegated with their size, anatomic location and influence on the cerebrospinal fluid (CSF). Symptomatic ACs is usually diagnosed in the first or second decades of life due to increased intracranial pressure, craniomegaly or developmental delay. The definition of meditational goiter (MG) generally refers to a stoma with location for at least 50% of its volume in substernal position [3]. MG is a rare disease that generally diagnosed incidentally, and up to 40% of MGs are asymptomatic [4]. They may cause compressive symptoms in the surrounding tissues if they are large enough. Case ReportA sixtyeight year old right handed woman was admitted to our clinic with headache which increased for last six months and seizure complaintes. Physical examination of the patient's head, neck and abdomen were normal. Neurologic examination did not show any abnormalities. We check both the thyroid hormones and thyroid stimulation hormone levels routinely before operation and were normal. Computerized tomography (CT) and contrast enhanced magnetic resonance imaging (MRI) showed a 56x48x90 mm in size cytic lesion on the right occipital lobe of the brain which has very close relationship with the posterior pole of right lateral ventricle. The cyst did not enhanced after contrast media injection and reported as an AC. A right Cystoperitoneal shunting operation was planned. After entubation of the patient, a pillow was placed under the shoulders to provide extension to the neck.In a few minutes after positioning of the patient, a lump in 4x5 cm size appeared on the right anterolateral side of the neck, and the anesthesiologist said the patient had difficulty in ventilation. Ultra son graphic examination was performed in operating room and showed a nodule 43x66x78 mm in size which moved from right lobe of thyroid to the retrosternal region. The operation has cancelled, and position changed to normal which caused disappearing of the lesion. The patient extubated and detailed endocrinology and radiologic examination were planned. The patient consulted by general surgeon and they decided to operate the patient before cysto-peritoneal shunt operation.

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“…Video mediastinoskopinin retrosternal guatrlı 7 olguda başarılı bir şekilde uygulandığı Migliore ve ark. 18 şılaşılabilecek komplikasyonlar arasında rekürren sinir hasarı (%0-4), geçici veya kalıcı hipokalsemi (%0.4-8.4), hematom, pnömotoraks, pnömoni ve plevral effüzyon sayılabilir 21 . Sternotomi ile yaptığımız total tiroidektomi sonrası gerek ameliyat sırasında gerekse ameliyat sonrasında herhamgi bir komplikasyonla karşılaşmadık.…”

Section: Discussionunclassified

Thyroidectomy Requiring Sternotomy: Goiter Reaching the Carina

Çelebi¹,

Özkan²,

Gündüz³

et al. 2016

Sakarya Med J

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Retrosternal guatr veya intratorasik guatr, tiroid bezinin torasik kavite içerisine uzanımını ifade eden bir tanımlamadır. Lokalizasyonu itibariyle önemli kardiopulmoner semptomlara yol açabilmektedir. Bu yazıda üç yıl boyunca kronik obstrüktif akciğer hastalığı ve astım öntanılarıyla medikal tedavi uygulanmış olan retrosternal guatrlı bir hasta sunulmaktadır. Bu hastanın şikayetleri kısmi sternotomi ilave edilerek yapılan total tiroidektomi ameliyatı ile düzelmiştir. ( Sakarya Tıp Dergisi 2016, 6(3):161-165 ) Anahtar Kelimeler: Retrosternal guatr, kardiopulmoner semptomlar, Sternotomi AbstractRetrosternal goiter or intrathoracic goiteris a definition that refers to the extension of the thyroid gland into the thoracic cavity. Its localization can lead to serious cardiopulmonary symptoms. In this case report, a patient with retrosternal goiter who had undergone a three years of medical therapy for chronic obstructive pulmonary disease and asthma is presented. This patient's symptoms were improved by adding partial sternotomy to total thyroidectomy surgery. ( Sakarya Med J 2016, 6(3):161-165 )

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Cervico-mediastinal goiter: is telescopic exploration of the mediastinum (video mediastinoscopy) useful?☆

Cited by 20 publications

References 5 publications

Surgical management of intrathoracic goitres

Surgical management of intrathoracic goitres

A Mediastinal Goitre Case That Moving Upward To Neck during a Cystoperitoneal Shunting Operation

Thyroidectomy Requiring Sternotomy: Goiter Reaching the Carina

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