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Surgical Treatment of Retrosternal Goitre

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Indian Journal of Otolaryngology and Head & Neck Surgery Aims and scope Submit manuscript

Abstract

This study aims to evaluate surgical approaches to the management of retrosternal goitre. Between 2004 and 2014, 35 patients (eight males; mean age 67.4 ± 10.9 years) with retrosternal goitre (mainly right-sided in 9, left-sided in 14 and bilateral in 12) underwent surgery. A palpable neck mass was found in 11 (31.4%), stridor in 10 (28.6%) and thyrotoxicosis in 4 (11.4%) cases. 4 (11.4%) patients were asymptomatic. Tracheal compression was detected radiologically in 27 (77.2%) patients with deviation in 18 (51.4%). A collar incision was performed in 34 patients, 6 (17.1%) of whom required additional sternotomy, 1 (2.9%) was assisted by an anterior mediastinotomy. 1 (2.9%) had a right lateral thoracotomy. There was no operative mortality. Transient vocal changes occurred in 3 (8.6%) patients, recurrent laryngeal nerve palsy in 3, atrial fibrillation in 2, and wound complications in 2 (5.7%). Hospital stay ranged from 2 to 12 days (5.5 ± 2.0). Multinodular goitre was found in 33 patients, diffuse goitre in 1 and ectopic thyroid in 1. The average vertical length of goitres in the collar incision group was 7.6 cm compared to 10.6 cm in the sternotomy group. The average weight of specimens was 156.3 g in patients with collar incisions and 307.5 g in the sternotomy group. Removal of retrosternal goitre is more commonly performed via a cervical collar incision with mandatory availability of sternotomy. Radiological measurement of craniocaudal length may predict the risk of sternotomy. Surgical outcomes are not affected by surgical approach.

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References

  1. Coskun A, Yildirim M, Erkan N (2014) Substernal goiter: when is a sternotomy required? Int Surg 99:419–425

    Article  PubMed  PubMed Central  Google Scholar 

  2. Rodrigues J, Furtado R, Ramani A, Mitta N, Kudchadkar S, Falari S (2013) A rare instance of retrosternal goitre presenting with obstructive sleep apnoea in a middle-aged person. Int J Surg Case Rep 12:1064–1066

    Article  Google Scholar 

  3. Fan Q, Gong K, Zhu B, Zhang NW (2014) Experience of managing substernal goitre by totally endoscopic procedure. Beijing Da Xue Xue Bao 46:488–491

    PubMed  Google Scholar 

  4. Piao M, Yuan Y, Wang Y, Feng C (2013) Successful management of trachea stenosis with massive substernal goitre via tracheobronchial stent. J Cardiothorac Surg 8:212

    Article  PubMed  PubMed Central  Google Scholar 

  5. Schoenen J, Broux R, Moonen G (1992) Unilateral facial pain a the first symptom of lung cancer: are there diagnostic clues? Cephalalgia 12:178–179

    Article  CAS  PubMed  Google Scholar 

  6. Kacprzak G, Karas J, Rzechonek A, Blasiak P (2012) Retrosternal goitre located in the mediastinum: surgical approach and operative difficulties. Interact Cardiovasc Thorac Surg 15:935–937

    Article  PubMed  PubMed Central  Google Scholar 

  7. Chen X, Xu H, Ni Y, Sun K, Li W (2013) Complete excision of a giant thyroid goiter in posterior mediastinum. J Cardiothorac Surg 8:207

    Article  PubMed  PubMed Central  Google Scholar 

  8. McKenzie GA, Rook W (2014) Is it possible to predict the need for sternotomy in patients undergoing thyroidectomy with retrosternal extension? Interact Cardiovasc Thorac Surg 19:139–143

    Article  PubMed  Google Scholar 

  9. Sakkary MA, Abdelrahman AM, Mostafa AM, Abbas AA, Zedan MH (2012) Retrosternal goitre: the need for thoracic approach based on CT findings: surgeon’s view. J Egypt Natl Canc Inst 24:85–90

    Article  PubMed  Google Scholar 

  10. Naraynsingh V, Ramarine I, Cawich S, Maharaj R, Dan D (2013) Cervical leverage: a new procedure to deliver deep retrosternal goitres without thoracotomy. Int J Surg Case Rep 11:992–996

    Article  Google Scholar 

  11. Landerholm K, Järhult J (2014) Should asymptomatic retrosternal goitre be left untreated? A prospective single-centre study. Scand J Surg 23:1–4

    Google Scholar 

  12. Testini M, Gurrado A, Bellantone R, Brazzarola P, Cortese R, De Toma G et al (2014) Recurrent laryngeal nerve palsy and substernal goiter. An Italian multicenter study. J Visc Surg 151:183–189

    Article  CAS  PubMed  Google Scholar 

  13. Rolighed L, Rønning H, Christiansen P (2015) Sternotomy for substernal goiter: retrospective study of 52 operations. Langenbecks Arch Surg 400:301–306

    Article  PubMed  Google Scholar 

  14. Shaha AR, Jaffe BM (1998) Parathyroid preservation during thyroid surgery. Am J Otolaryngol 19:113–117

    Article  CAS  PubMed  Google Scholar 

  15. Gupta P, Lau KK, Rizvi I, Rathinam S, Waller DA (2014) Video assisted thoracoscopic thyroidectomy for retrosternal goitre. Ann R Coll Surg Engl 96:606–608

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Ahamat N (2012) Access all ages: assessing the impact of age on access to surgical treatment. Bull R Coll Surg Engl 94(9):300

    Article  Google Scholar 

Download references

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Authors and Affiliations

  1. Department of Thoracic Surgery, The Royal Brompton and Harefield Hospital NHS Foundation Trust, Harefield Hospital, Hill End Road, Harefield, Middlesex, London, UB9 6JH, UK

    Kiera Welman, Paras Dalal, Sarah Hough, Marciano Bunalade & Vladimir Anikin

  2. Department of Otolaryngology, Head and Neck Surgery, London North West Healthcare NHS Trust, Northwick Park Hospital, London, UK

    Richard Heyes

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  1. Kiera Welman
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  2. Richard Heyes
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  3. Paras Dalal
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  4. Sarah Hough
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  5. Marciano Bunalade
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  6. Vladimir Anikin
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Correspondence to Kiera Welman.

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Conflict of interest

The author(s) declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Welman, K., Heyes, R., Dalal, P. et al. Surgical Treatment of Retrosternal Goitre. Indian J Otolaryngol Head Neck Surg 69, 345–350 (2017). https://doi.org/10.1007/s12070-017-1151-0

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  • DOI: https://doi.org/10.1007/s12070-017-1151-0

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