Substernal goiter: Experience with 50 cases

Benbakh, M.; Abou-Elfadl, M.; Rouadi, Sami; Abada, R.; Roubal, M.; Mahtar, Mohamed

doi:10.1016/j.anorl.2015.09.007

Cited by 20 publications

(19 citation statements)

References 12 publications

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“…To assess the spread of mediastinal goiter, Benbakh et al classified 90% of patients according to the aortic arch and trachea in CT and they did not separate the thyroid lobes, as right and left, differently from ours. In this study, prevascular and aortic upper arch were the most common type of dissemination 16. According to the anatomical classification of Huins et al which is made before surgical approach by Dempsey et al, prior to the surgical approach, the spread of RSG above the aortic arch was the most common group 17.…”

Section: Discussionmentioning

confidence: 58%

Retrosternal Goiter: A couple of classification methods with computed tomograpy findings

2018

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Objectives:The retrosternal goiter (RSG), which can be defined by different classification and its incidence between 2% and 26% of all thyroidectomized patients, is a thyroid gland disease. Our aim was to classify RSG cases with a couple of different ways, which we have detected in computed tomography (CT) imaging of the thorax.Methods:In this retrospective study conducted at Kars Harakani State Hospital Pulmonary Medicine Polyclinic between June 2014 and June 2017 in which 176 patients were included. The age, sex, diagnostic codes, retrosternal extension of the thyroid gland (aortic upper arch, aortic reaching arch and aortic inferior arch), extension type (prevascular, paratracheal retrovascular and retrotracheal), extension amount (mm) (<50% and 50%<) of thyroid gland of the patients were assessed.Results:About 56.25% (n=99) were female and the mean age was 65.9±11.4 years. The most common co-morbid disease in patients with RSG was Chronic Obstructive Pulmonary Disease (COPD) (52.3%). Thirty nine (22.2%) of the patients had associated nodule, 16 (9.1%) had accompanying tracheal pressure and one patient had nodule and tracheal pressure. 27.3% of the patients’ gland’s right lobe and 28.9% of the patients’ left lobe were extended >50% below the thoracic entry. Left thyroid gland’s (90.3%) retrosternal extension and aortic arch spread (91.2%) were more. When classified according to the trachea, the left lobe’s paratracheal and retrovascular extension (50.9%) was more. Extension amounts were similar for both thyroid lobes.Conclusion:In patients who have retrosternal goiter, goiter spread can be defined with multiple classification with thorax CT.

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Section: Discussionmentioning

confidence: 58%

Retrosternal Goiter: A couple of classification methods with computed tomograpy findings

2018

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“…The most common complication is transient hypocalcemia, and its frequency is reported to range from 2 to 28.9%. On the other hand, it was reported that the frequency of permanent hypocalcemia ranges from 0 to 8.1% [ 1 , 2 , 5 , 6 , 16 ]. In the present case, transient hypocalcemia was observed, but it subsequently resolved.…”

Section: Discussionmentioning

confidence: 99%

A Large Substernal Goiter that Extended to Both Sides of the Thorax

Nakayama

Goda

Kohagura

et al. 2018

Case Reports in Surgery

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Most substernal goiters can be managed through the transcervical approach, but a sternotomy is required in some cases. This report is about a large substernal goiter, which was resected via a transcervical and full sternotomy approach. The patient was a 57-year-old female, who visited our hospital for surgical treatment for a large substernal goiter. Computed tomography of the neck and chest revealed that the substernal goiter extended to both sides of the thorax and had compressed the trachea. We performed total thyroidectomy safely via a transcervical and full sternotomy approach. No postoperative complications occurred, except transient hypocalcemia. A histopathological examination did not reveal any malignancy, and the lesion was diagnosed as an adenomatous goiter. Most substernal goiters can be managed through the transcervical approach, but a full sternotomy is required when a substernal goiter extends to both sides of the thorax and/or has a larger diameter than the thoracic inlet or airway constriction is revealed. A full sternotomy provides excellent exposure and can help reduce the risk of complications, such as recurrent laryngeal nerve palsy and injuries to major blood vessels.

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“…Historical factors worrisome for progressive obstruction include longstanding goiter, cough, dysphagia, hoarse voice, or superior vena cava syndrome (SVCS). 11 – 13 Exertional dyspnea is frequently experienced when tracheal diameter is compressed to less than eight millimeters, and stridor manifests when the lumen is less than five millimeters. 14 Positional changes, such as reaching forward, bending at the waist and lying supine, can provoke symptoms of obstruction.…”

Section: Resident Discussionmentioning

confidence: 99%