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    435 results match your criteria Thyroid Substernal Goiter

    1 OF 9

    Substernal Goiter: Correlation between Grade and Surgical Approach.
    Am Surg 2018 Feb;84(2):262-266
    Substernal goiter is defined as a thyroid growth beyond the thoracic inlet. Using the cross-section imaging CT system, it can be classified into three grades. The aim of the study was to validate the surgical approach and the occurrence of postoperative complications with substernal goiter extension in our patient population. Read More

    Medial Approach for the Resection of Goiters with Suprahyoid, Retropharyngeal, or Substernal Extension.
    World J Surg 2018 05;42(5):1415-1423
    Department of Otolaryngology - Head and Neck Surgery, University of Nevada Las Vegas School of Medicine, 1701 W Charleston Blvd, Suite 490, Las Vegas, NV, 89102, USA.
    Background: Resection of massive goiters with suprahyoid, retropharyngeal, and substernal extension may not be amenable to standard approaches. This study evaluates a surgical approach allowing resection of massive goiters with minimal substernal and deep neck dissection.

    Methods: Cases of thyroidectomy for goiters with substernal, retropharyngeal, or suprahyoid extension at a single institution from 2006 to 2017 were reviewed. Read More

    Indications and contraindications to transoral thyroidectomy.
    Ann Thyroid 2017 31;2(5). Epub 2017 Oct 31.
    Division of Head and Neck Endocrine Surgery, Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
    Patient motivation to avoid neck scarring has been a strong impetus in the development of remote access approaches to the thyroid, including transoral robotic or endoscopic thyroidectomy vestibular approach (TOR/ETVA). TOR/ETVA continues to become more prevalent given its early success in North America and the demonstration of its safety and efficacy in Asia. As more surgeons perform this procedure, it is important that specific and uniform indications and contraindications exist to prevent surgical complications due to poor patient selection. Read More

    Rare Undiagnosed Primary Amyloidosis Unmasked During Surgical Treatment of Primary Hyperparathyroidism: A Case Report.
    J Endocr Soc 2018 Feb 3;2(2):112-116. Epub 2018 Jan 3.
    Division of Surgical Oncology and Endocrine Surgery, Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee 37232.
    Primary amyloidosis (PA) is a protein deposition disorder that presents with localized or multisystemic disease. The incidence is low in the general public, ranging from three to eight cases per million, and with nonspecific presenting symptoms typically occurring later in life. Due to late presentation, substantial and irreversible damage has usually already occurred by the time of the diagnosis. Read More

    Cancer Frequency in Retrosternal Goiter.
    Am Surg 2017 Dec;83(12):1390-1393
    Retrosternal goiter prevalence is 5 to 40 per cent according to classifications in goiter series. Goiters with mediastinal extension were reported to be related with higher cancer rates. In our study, we aimed to investigate whether cancer incidence increased in retrosternal goiters compared with the cervical ones. Read More

    Trans-cervical resection of a separate substernal goitre.
    Int J Surg Case Rep 2017 10;41:373-376. Epub 2017 Nov 10.
    Department of Surgery, The Northern Hospital, 185 Cooper St, Epping, Victoria, 3076, Australia.
    Introduction: A separate substernal goitre which is not continuous with the main cervical thyroid proves a unique challenge for resection. A trans-cervical approach is preferred but may be hazardous due to the possibility of ectopic thyroid tissue with alternate blood supply.

    Presentation Of Case: A 72year old female who had a previous left hemithyroidectomy presents with a symptomatic central substernal thyroid mass. Read More

    Simultaneous unilateral anterior thoracoscopy with transcervical thyroidectomy for the resection of large mediastinal thyroid goiter.
    J Thorac Dis 2017 Aug;9(8):2484-2490
    Division of Otolaryngology, Department of Surgery, Maimonides Medical Center, Brooklyn, NY, USA.
    Background: Almost 25% of thyroid goiters have an intrathoracic component. Although the majority of mediastinal goiters may be approached through a cervical approach, up to a third of substernal goiters require a sternotomy or thoracotomy for resection. As an alternative to conventional sternotomy, we herein describe a combined anterior thoracoscopic and transcervical approach to large mediastinal thyroid goiters. Read More

    Safety and Outcomes of the Transoral Endoscopic Thyroidectomy Vestibular Approach.
    JAMA Surg 2018 Jan;153(1):21-27
    Department of Surgery, University of California, San Francisco.
    Importance: Natural orifice transluminal endoscopic surgery thyroidectomy is a novel approach to avoid surgical scars.

    Objective: To compare the safety and outcomes of the transoral endoscopic thyroidectomy vestibular approach (TOETVA) with those of open thyroidectomy (OT).

    Design, Setting, And Participants: This study retrospectively reviewed all TOETVA and OT operations performed from April 1, 2014, through August 31, 2016, at Police General Hospital, Bangkok, Thailand. Read More

    The Value of Preoperative Volumetric Analysis by Computerised Tomography of Retrosternal Goiter to Predict the Need for an Extra-Cervical Approach.
    Balkan Med J 2018 Jan 25;35(1):36-42. Epub 2017 Aug 25.
    Clinic of General Surgery, Amerikan Hospital, İstanbul, Turkey.
    Background: A thyroidectomy can be performed via a cervical incision in most patients with retrosternal goiter.

    Aims: To investigate the correlation between the volume of the mediastinal portion of the thyroid gland and the need for an extra-cervical approach for retrosternal goiter.

    Study Design: Diagnostic accuracy study. Read More

    Substernal goiter and laryngopharyngeal reflux.
    Arch Endocrinol Metab 2017 Jul-Aug;61(4):348-353. Epub 2017 Jun 26.
    Disciplina de Cirurgia de Cabeça e Pescoço do Hospital das Clínicas da FMUSP, São Paulo, SP, Brasil.
    Objective: This study aims to compare the prevalence of laryngopharyngeal reflux signs between two groups of patients undergoing thyroidectomy for voluminous goiter: substernal goiters and voluminous cervical goiter without thoracic extension.

    Subjects And Methods: A retrospective case-control study was performed with data retrieved of the charts of the patients submitted to thyroidectomies occurred at a tertiary care center (Head and Neck Surgery Department, University of São Paulo Medical School) between 2010 and 2014. The selected thyroidectomies were allocated in two groups for study: patients with substernal goiters and patients with voluminous cervical goiter without thoracic extension. Read More

    Morbidity of total thyroidectomy for substernal goiter: A series of 70 patients.
    J Visc Surg 2018 Feb 8;155(1):11-15. Epub 2017 Jun 8.
    Service de chirurgie digestive et viscérale, hôpital Trousseau, avenue de la République, 37170 Chambray-lès-Tours, France.
    Total thyroidectomy for substernal goiter occasionally requires a sternotomy associated with a cervical incision. We sought to analyze the postoperative complications of thyroidectomy for substernal goiters in our center and more precisely the complications related to the sternotomy. All patients who underwent total thyroidectomy for substernal goiter in our center between 2007 and 2016 were reviewed retrospectively. Read More

    Patient-tailored management of an asymptomatic massive substernal goiter presenting as brachiocephalic vein occlusion. Report of a case and review of sternotomy indications.
    Int J Surg Case Rep 2017 4;31:35-38. Epub 2017 Jan 4.
    1st Department of Surgery, 401 Army General Hospital of Athens, Greece.
    Introduction: Substernal goiters are characterized by the protrusion of at least 50% of the thyroid mass below the level of the thoracic inlet. Still their definition is controversial.

    Case Presentation: The case refers to a 44year old male who presented to our department due to swelling and a feeling of 'heaviness' of his left upper extremity for the past 6 months. Read More

    Airway Obstruction Caused by Substernal Thyrotoxic Multinodular Goiter.
    Tokai J Exp Clin Med 2016 Dec 20;41(4):181-184. Epub 2016 Dec 20.
    Department of Medicine, Kanagawa Dental University Graduate School, 82 Inaoka-cho, Yokosuka, Kanagawa 238-8580, Japan.
    Background: Substernal thyrotoxic multinodular goiter (MNG) shows signs and symptoms as a result of compression of adjacent organs and thyrotoxicosis. However, acute airway obstruction is rarely caused by substernal thyrotoxic MNG.

    Case Report: We have described a 56-year-old Japanese woman who demonstrated acute airway obstruction because of compression of the airway by substernal thyrotoxic MNG. Read More

    Diagnostic value of conventional chest radiography in intrathoracic goiters-retrospective analysis of 2570 patients.
    Langenbecks Arch Surg 2017 Mar 24;402(2):251-255. Epub 2016 Nov 24.
    Endocrine Surgery Department, Hôpital Européen, 6 rue Désirée Clary, 13003, Marseille, France.
    Purpose: Since intrathoracic goiters (IG), either cervico-mediastinal goiters (CMGs) or mediastinal nodules (MNs), can lead to sternotomies and/or evitable reoperations, their detection is mandatory before thyroid surgery. A systematic screening by CT scan or MRI is not conceivable because of their expensiveness. We tested if conventional chest radiography (CCR) could remain a good screening tool for IG before thyroid surgery. Read More

    Delayed Presentation of Forgotten Thyroid Goiter - 25 Years After Thyroidectomy.
    J Coll Physicians Surg Pak 2016 Oct;26(10):858-860
    Section of Cardiothoracic Surgery, The Aga Khan University Hospital, Karachi.
    Forgotten goiter is a rare occurrence (2 - 16% of retrosternal thyroid cases) that depicts recurrence of retrosternal thyroid mass due to growth of remnant thyroid tissue overlooked during an initial thyroidectomy. The patient is a 59-year female who presented with dyspnea and stridor 25 years after total thyroidectomy. She was diagnosed as having a mediastinal mass on radiographic imaging. Read More

    Strategies of laparoscopic thyroidectomy for treatment of substernal goiter via areola approach.
    Surg Endosc 2016 11 22;30(11):4721-4730. Epub 2016 Mar 22.
    Department of General Surgery, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China.
    Background: This study was aimed at exploring the feasibility and strategies of laparoscopic thyroidectomy for treatment of substernal goiter via areola approach.

    Methods: A retrospective analysis was conducted to investigate 15 cases of laparoscopic resection of substernal goiter via the areola approach (laparoscopic group) and 12 cases of open resection of substernal goiter via low-neck collar cervical approach (open group) that was completed between December 2012 and December 2014. Operative time, estimated blood loss, postoperative hospitalization and postoperative complication were compared. Read More

    Advanced vessel sealing devices in total thyroidectomy for substernal goitre: A retrospective cohort study.
    Int J Surg 2016 Nov 28;35:160-164. Epub 2016 Sep 28.
    Unit of Endocrine, Digestive, and Emergency Surgery, Department of Biomedical Sciences and Human Oncology, University Medical School "A. Moro" of Bari, Piazza Giulio Cesare 11, 70124, Bari, Italy. Electronic address:
    Introduction: When total thyroidectomy is performed for substernal goitre, a high risk of morbidity is reported. Advanced vessel sealing devices provide an alternative to the conventional clamp and tie technique. The aim of this study is to compare the outcome of patients who underwent total thyroidectomy for substernal goitre using Ligasure Small Jaw, Harmonic Focus, or conventional technique. Read More

    Anatomical approach to surgery for intrathoracic goiter.
    Eur Arch Otorhinolaryngol 2017 Feb 29;274(2):1029-1034. Epub 2016 Sep 29.
    Department of Radiology, Assaf HaRofeh Medical Center, Affiliated To the Sackler Faculty of Medicine, Tel Aviv University, Bat Yam, Israel.
    The anatomical approach to the intrathoracic goiter (ITG) was used to understand its etiology and to rationalize surgical technique of thyroidectomy. For a retrospective chart review, we selected cases of multinodular goiter with totally ITGs (n = 69; M 29, F 40), while 916 cases with cervical goiter were used for comparison. The topography of the thyroid gland was assessed against the tracheal rings and against the vertebrae. Read More

    Forgotten goiter: Diagnosis and management. A case report and literature review.
    Int J Surg Case Rep 2016 5;27:192-194. Epub 2016 Sep 5.
    Florida International University Herbert Wertheim College of Medicine, American University of Antigua College of Medicine, United States. Electronic address:
    Introduction: A mediastinal thyroid mass discovered years after a total thyroidectomy represents an unusual and uncommon clinical situation. Few cases have been reported and controversy exists regarding the etiology of this ectopic thyroid tissue as well as the optimal surgical approach for resection. We herein describe a case of a mediastinal thyroid goiter discovered five years after a total thyroidectomy. Read More

    Retrosternal Goiter: 30-Day Morbidity and Mortality in the Transcervical and Transthoracic Approaches.
    Otolaryngol Head Neck Surg 2016 10 24;155(4):568-74. Epub 2016 May 24.
    Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Medical Center, New York, New York, USA.
    Objective: Retrosternal goiters pose a significant challenge in determining the indications and appropriate approach for surgical removal while limiting postoperative morbidity and mortality. The objective of this study is to use the National Surgical Quality Improvement Program (NSQIP) database to compare outcomes of transcervical and transthoracic approaches for retrosternal goiter removal and to review the literature regarding the varying indications for the 2 surgical approaches.

    Study Design: Administrative database analysis. Read More

    An extended toboggan technique for resection of substernal thyroid goiters.
    Ear Nose Throat J 2016 Apr-May;95(4-5):175-7
    Department of Otolaryngology, Mount Sinai West Hospital, 425 W. 59th St., 10th Floor, New York, NY 10019, USA.
    We describe our technique for the safe resection of substernal thyroid goiters. Early mobilization of the thyroid gland from tracheal attachments anteriorly and laterally facilitates extraction of the goiter from the mediastinum. Retrograde dissection through the ligament of Berry on the ipsilateral side can also facilitate identification of the recurrent laryngeal nerve and delivery of the substernal portion of the gland. Read More

    Haemostasis in Thyroid Surgery: Collagen-Fibrinogen-Thrombin Patch versus Cellulose Gauze-Our Experience.
    Surg Res Pract 2016 25;2016:3058754. Epub 2016 Feb 25.
    Department of Medical and Surgical Science, University of Foggia, Luigi Pinto Street 1, 71122 Foggia, Italy.
    Purpose. Postoperative hemorrhage is fortunately uncommon but potentially life-threatening complication of thyroid surgery that increases the postoperative morbidity and the hospital stay. In this study we compare the efficacy of collagen patch coated with human fibrinogen and human thrombin (CFTP) (group C) and oxidized regenerated cellulose gauze (group B) versus traditional hemostatic procedures (group A) in thyroid surgery. Read More

    Comparison of the results of total thyroidectomy and Dunhill operation in surgical treatment of multinodular goiter.
    Indian J Surg 2015 Dec 24;77(Suppl 3):1137-41. Epub 2015 Mar 24.
    Student Research Committee, Guilan University of Medical Sciences, Rasht, Iran.
    Multi-nodular goiter (MNG) is one of the commonest thyroid gland disease. Surgery is an important treatment option in the presence of indications. There are several alternative procedures for thyroid gland operation such as subtotal thyroidectomy (STT), near-total thyroidectomy (NTT), hemi-thyroidectomy plus subtotal resection (Dunhill procedure), and total thyroidectomy (TT), but the surgical procedure of choice is still under discussion. Read More

    Surgical treatment of substernal goiter: An analysis of 44 cases.
    Auris Nasus Larynx 2017 Feb 17;44(1):111-115. Epub 2016 Mar 17.
    Department of Otolaryngology-Head and Neck Surgery of the Tokyo Metropolitan Tama Medical Center, Japan.
    Objective: Substernal goiters are classified as primary or secondary intrathoracic goiters. Here, we report the diagnosis, symptoms, treatment, and postoperative complications of 44 substernal goiters (2 primary mediastinal goiter and 42 secondary mediastinal goiters).

    Methods: A retrospective chart review of 351 patients undergoing thyroidectomy at the Department of Otolaryngology-Head and Neck Surgery of the Tokyo Metropolitan Tama Medical Center. Read More

    Demographics, disparities, and outcomes in substernal goiters in the United States.
    Am J Surg 2016 Apr 6;211(4):703-9. Epub 2016 Jan 6.
    Thyroid and Parathyroid Surgery Program, Department of Surgery, Thomas Jefferson University, 1100 Walnut St., Suite 500, Philadelphia, PA, USA. Electronic address:
    Background: Disparities distinguishing patients with substernal goiters from nonsubsternal goiters have not been thoroughly described.

    Methods: The National Inpatient Sample database was used to compare patients who underwent substernal thyroidectomy years 2000 to 2010 with those who underwent thyroidectomy for nonsubsternal goiter.

    Results: A total of 110,889 patients underwent thyroidectomy for goiter (5,525 substernal and 105,364 nonsubsternal). Read More

    Surgical management of substernal goitres at a tertiary referral centre: A retrospective cohort study of 2,104 patients.
    Int J Surg 2016 Mar 2;27:46-52. Epub 2016 Feb 2.
    Department of Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan; Chang Gung University, Kwei-Shan Tao-Yuan, Taiwan. Electronic address:
    Background: When to use a thoracic approach to treat substernal goitres has often been discussed in the literature. But there are few published reports describing surgical outcomes and associated complications for patients with right-sided vs. left-sided substernal goitres. Read More

    Surgical management of cervico-mediastinal goiters: Our experience and review of the literature.
    Int J Surg 2016 Apr 23;28 Suppl 1:S47-53. Epub 2015 Dec 23.
    Department of Medicine and Surgery, Thoracic Surgery Unit, University of Salerno, Italy. Electronic address:
    Aim: We analyze and discuss the clinical presentation, the diagnostic procedures and the surgical technique in relation to post-operative complications and results in cervico-mediastinal thyroid masses admitted in Thoracic Surgery Unit of AOU Second University of Naples from 1991 to 2006 and in Thoracic Surgery Unit of AOU "S. Giovanni di Dio & Ruggi D'Aragona" of Salerno over a period of 3 years (2011-2014).

    Methods: We reviewed 97 patients who underwent surgical treatment for cervico-mediastinal goiters. Read More

    Substernal goiter: Experience with 50 cases.
    Eur Ann Otorhinolaryngol Head Neck Dis 2016 Feb 29;133(1):19-22. Epub 2015 Oct 29.
    Service d'ORL et de chirurgie cervico-faciale, hôpital 20 Août, CHU Ibn-Rochd, Casablanca, Morocco.
    Introduction: Goiter is localized or generalized thyroid hypertrophy. It is usually cervical, but may show intra-thoracic development beyond the thoracic inlet and down to the mediastinum: i.e. Read More

    Postoperative Acute Respiratory Failure In Patients Treated Surgically For Goiters.
    Pol Przegl Chir 2015 Jul;87(7):331-5
    Unlabelled: The aim of the study was to present a clinical picture, treatment and prognosis regarding patients who developed acute respiratory failure (ARF) while treated surgically for a goiter.

    Material And Methods: A total of 3810 patients were treated for goiters between 2008 to 2013. Symptoms of postoperative ARF were recognized in 39 (1%) patients. Read More

    Does a combined procedure for cardiac surgery and thyroidectomy offer acceptable outcomes?
    Interact Cardiovasc Thorac Surg 2015 Dec 3;21(6):787-91. Epub 2015 Sep 3.
    The University of New South Wales, Sydney, Australia Department of Cardiothoracic Surgery, Liverpool Hospital, Sydney, Australia.
    This best evidence topic on cardiothoracic surgery was written using a structured protocol. The question addressed was: 'in an adult patient requiring cardiac surgery, can a thyroidectomy for a large retrosternal goitre be performed with good outcomes as a combined procedure?' Of 150 papers identified through the literature search, 16 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, study type, patient group studied, relevant outcomes and results were tabulated. Read More

    [In Process Citation].
    Magy Seb 2015 Aug;68(4):173-5
    Fej-Nyaki Daganatok Multidiszciplináris Centrum, Országos Onkológiai Intézet 1124 Budapest, Ráth György utca 7-9.
    Introduction: The presence of a substernal goiter which compresses the adjacent structures is per se an indication for resection, mostly total thyreoidectomy should be performed either by a head and neck or general surgeon. In about 1-10% of the cases the goiter is located behind the sternum, and the removal requires different surgical technique.

    Materials And Methods: Authors operated 182 patients between 2000-2014 with substernal goiter which all reached the level of the jugulum. Read More

    Surgery of the thyroid: recent developments and perspective.
    Swiss Med Wkly 2015 28;145:w14144. Epub 2015 Jul 28.
    Geneva University Hospitals and Faculty of Medicine, Reu Gabrielle Perret-Gentil 4, 1211, Geneva, SWITZERLAND.
    In the past century, thyroid surgery has benefited from physiological and technical revolutions. In the early 1900s, the most important aspect of thyroidectomy was the volume resected, without knowledge of exactly what was removed and if there were important structures around the thyroid gland. The main indications were respiratory problems for tracheal compression and the death rate was greater than 36% due to bleeding, infections, unrecognised bilateral recurrent laryngeal nerve lesions and unrecognised severe hypocalcaemia leading to tetany. Read More

    Substernal goiter: when is a sternotomy required?
    J Surg Res 2015 Nov 18;199(1):121-5. Epub 2015 Apr 18.
    Section of Endocrine Surgery, Department of Surgery, University of Wisconsin, Madison, Wisconsin; Wisconsin Surgical Outcomes Research (WiSOR) Program, Department of Surgery, University of Wisconsin, Madison, Wisconsin. Electronic address:
    Background: Sternotomy for substernal goiters (SSG) is associated with greater morbidity than a cervical approach to thyroidectomy. We sought to identify predictors for sternotomy as a surgical approach for the removal of SSG and analyzed the preoperative and postoperative characteristics of patients with SSG compared with those with large goiters contained entirely within the neck or a cervical goiter.

    Methods: A retrospective review of a surgical database was performed. Read More

    Parathyroid Localization and Preservation during Transcervical Resection of Substernal Thyroid Glands.
    Otolaryngol Head Neck Surg 2015 Jun 6;152(6):1024-8. Epub 2015 Apr 6.
    Weill Cornell Medical College/New York Presbyterian, Department of Otolaryngology-Head and Neck Surgery, New York, New York, USA
    Objective: The feasibility of parathyroid preservation during thyroidectomy has not been well documented for cases in which the thyroid gland extends into the mediastinum.

    Study Design: Retrospective chart review.

    Setting: Tertiary academic referral center. Read More

    Transient palsy of recurrent laryngeal nerve postresection of giant substernal goiter.
    Thorac Cardiovasc Surg Rep 2014 Dec 27;3(1):51-4. Epub 2014 Feb 27.
    Department of Cardiothoracic Surgery, Second Xiangya Hospital of Central South University, Changsha, Hunan, China ; Key Laboratory of Carcinogenesis and Cancer Invasion, Cancer Research Institute, Xiangya School of Medicine, Central South University, Changsha, Hunan, China.
    We report a case of a female patient aged 46 years with a history of nodular goiter for which she had a subtotal thyroidectomy 31 years ago. She was referred to the emergency department of our hospital because of dyspnea and chest pain for 20 days, then developed cyanosis and edema of the head and upper extremities. Chest X-ray revealed tracheal repulsion. Read More

    Sternotomy for substernal goiter: retrospective study of 52 operations.
    Langenbecks Arch Surg 2015 Apr 19;400(3):301-6. Epub 2015 Feb 19.
    Breast and Endocrine Section, Department of Surgery P, Aarhus University Hospital, Tage Hansens Gade 2, 8000, Aarhus, Denmark,
    Purpose: Surgical treatment of substernal goiter occasionally involves sternotomy. Classification and handling of these operations are widely discussed. We aimed to review surgical results after thyroid operations including median sternotomy. Read More

    Computed tomography for preoperative evaluation of need for sternotomy in surgery for retrosternal goitre.
    Langenbecks Arch Surg 2015 Apr 4;400(3):293-9. Epub 2015 Jan 4.
    Section for Endocrine Surgery and Abdominal Sarcoma, Department of Surgery, Institute of Clinical Sciences, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden.
    Purpose: The purposes of this study are to evaluate the usefulness of available CT classifications of retrosternal goitre (RSG) to identify patients needing sternotomy and to examine the effect of neck extension on goitre position.

    Methods: From the Scandinavian Quality Register for Thyroid and Parathyroid Surgery, all patients treated for RSG at Sahlgrenska (January 2005 through August 2012) were identified. Medical records and preoperative CT scans were retrospectively reviewed. Read More

    Myasthenic Crisis Manifesting as Postoperative Respiratory Failure following Resection of Unsuspected Intrathoracic Thymic T-Cell Lymphoma during Thyroidectomy for an Adjacent Large Retrosternal Goiter.
    Eur Thyroid J 2014 Sep 9;3(3):206-10. Epub 2014 Aug 9.
    University of Khartoum, Khartoum, Sudan.
    A middle-aged female with a goiter of 10 years' duration presented with progressive pressure symptoms, nocturnal choking and dyspnea on exertion for 5 months. Physical examination demonstrated a large simple multinodular goiter. Imaging revealed a deep retrosternal goiter extending below the tracheal bifurcation with marked tracheal deviation. Read More

    Acute airway obstruction due to spontaneous intrathyroid hemorrhage precipitated by anticoagulation therapy.
    Indian J Crit Care Med 2014 Dec;18(12):825-7
    Department of Pulmonary and Critical Care, University of Arkansas for Medical Science, Arkansas, USA.
    Acute airway compromise due to hemorrhage in of thyroid gland is a rare life-hreating condition. The increasing use of anticoagulants for various reasons is likely increased the occurrence of this this complication. We describe an elderly patient on anticoagulation for atrial fibrillation, which developed swelling on the right side of neck causing acute airway obstruction requiring emergency intubation for airway protection. Read More

    Substernal thyroid biopsy using Endobronchial Ultrasound-guided Transbronchial Needle Aspiration.
    J Vis Exp 2014 Nov 10(93):e51867. Epub 2014 Nov 10.
    Interventional Pulmonology Section, Division of Medicine, Roswell Park Cancer Institute, State University of New York, Buffalo.
    Substernal thyroid goiter (STG) represents about 5.8% of all mediastinal lesions(1). There is a wide variation in the published incidence rates due to the lack of a standardized definition for STG. Read More

    Thyroid cancer & sarcoidosis.
    Sarcoidosis Vasc Diffuse Lung Dis 2014 Oct 20;31(3):239-43. Epub 2014 Oct 20.
    Cleveland Clinic Foundation.
    Unlabelled: The association of thyroid cancer and SA has been previously described in individual case reports. We are describing 4 patients with co-existence of papillary thyroid cancer (PTC) and SA who presented a diagnostic and management challenge.

    Patients: One patient (Patient 1) with known history of SA was referred for thyroid nodules and cervical adenopathies; Fine needle aspiration (FNA) showed PTC. Read More

    Video assisted thoracoscopic thyroidectomy for retrosternal goitre.
    Ann R Coll Surg Engl 2014 Nov;96(8):606-8
    University Hospitals of Leicester NHS Trust, UK.
    Introduction: Thyroidectomy for retrosternal goitre is usually carried out through a cervical incision. Around 4-12% of patients, however, require an extracervical approach, usually by sternotomy. Anatomically, the thyroid extends deep behind the great vessels in the pretracheal fascia. Read More

    Unanticipated thyroid cancer in patients with substernal goiters: are we underestimating the risk?
    Ann Surg Oncol 2015 Apr 15;22(4):1214-8. Epub 2014 Oct 15.
    Department of Surgery, University of California, Sacramento, CA, USA,
    Background: The rate of unexpected thyroid cancers found at the time of thyroidectomy is thought to be similar in patients with cervical and substernal multinodular goiters (MNGs).

    Methods: The objective of this study was to compare the prevalence of undiagnosed cancer found in patients undergoing a thyroidectomy for a cervical or substernal MNG. We conducted a review of patients with a preoperative diagnosis of an MNG (both cervical and substernal) at a tertiary referral center between 2005 and 2012. Read More

    US not bright but right method of thyroid volume estimation even in large and substernal extended goitres. Comparison of US and three methods of CT thyroid evaluation – prospective study.
    Clin Endocrinol (Oxf) 2015 Sep 27;83(3):412-9. Epub 2014 Nov 27.
    Department of Endocrinology and Internal Medicine, Medical University of Gdansk, Gdansk, Poland.
    Background: Ultrasound is nowadays a method of choice for thyroid volume assessment. However, its disadvantage is some inaccuracy, which is said to be higher in huge, especially substernally extended goitres.

    Aims: The aim of the study was to compare the US and CT thyroid volumetric measurements: multi-observers (CT MO) and one-observer (CT OO) to CT planimetry results (CT Pl) in patients with large goitres. Read More

    Substernal goiter: when is a sternotomy required?
    Int Surg 2014 Jul-Aug;99(4):419-25
    Izmir Bozyaka Training and Research Hospital, Department of Surgery, Izmir, Turkey.
    The presence of substernal goiter is, per se, an indication for surgical management. Surgical approach of substernal goiter can most commonly be performed using the cervical access, but at times, a sternotomy or thoracotomy is necessary. The aim of this study was to identify the preoperative predictors of a sternotomy in the management of substernal goiter in order to provide better preoperative planning and patient consent. Read More

    Recurrent laryngeal nerve palsy and substernal goiter. An Italian multicenter study.
    J Visc Surg 2014 Jun 28;151(3):183-9. Epub 2014 May 28.
    Department of Surgery, Endocrine Surgical Unit, Ivrea Hospital, Ivrea, Italy.
    The aim of this retrospective multicenter study was to verify whether the substernal goiter and the type of surgical access could be risk factors for recurrent laryngeal nerve palsy during total thyroidectomy. Between 1999-2008, 14,993 patients underwent total thyroidectomy. Patients were divided into three groups: group A (control; n=14. Read More

    Should asymptomatic retrosternal goitre be left untreated? A prospective single-centre study.
    Scand J Surg 2015 Jun 23;104(2):92-5. Epub 2014 Apr 23.
    Department of Surgery, Ryhov County Hospital, Jönköping, Sweden Department of Surgery, Highland Hospital, Eksjö, Sweden.
    Background And Aims: Retrosternal goiter may cause symptoms of airway obstruction and dysphagia, but often it is asymptomatic and is increasingly detected incidentally with imaging investigations. Consensus has been reached that sternotomy is not necessary in most cases, as a collar incision normally suffices. Yet, surgery for retrosternal goiter is associated with more complications than cervical goiter. Read More

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