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Cervicothoracic goitre: an anatomical or radiological definition? Report of 223 surgical cases

Published online by Cambridge University Press:  15 March 2007

C Page  and
V Strunski
C Page*
Affiliation:
Anatomy Department, School of Medicine, ‘Jules Verne’ University, Amiens, France ENT and Head and Neck Surgery Department, University Hospital of Amiens, France.
V Strunski
Affiliation:
Anatomy Department, School of Medicine, ‘Jules Verne’ University, Amiens, France
*
Address for correspondence: Dr Cyril Page, Centre Hospitalier Nord, Place Victor Pauchet, 80054 Amiens cedex, France. Fax: 03 22 66 86 23 E-mail: cyril_page@yahoo.fr
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Abstract

Objectives:

To analyse and compare chest radiographs and cervicothoracic computed tomography scans taken prior to thyroid surgery, in order to locate and predict thoracic extension of substernal goitres.

Method:

This eight-year, retrospective study included 223 patients who had undergone total thyroidectomy for benign, substernal, multinodular goitres. Chest radiographs and computed tomography scans were reviewed by two physicians (a senior ENT surgeon and a senior radiologist).

Results:

The most frequent mode of extension was anterior or prevascular, seen in 76 per cent of cases, especially on the left side. Fifty-nine per cent of goitres did not reach the aortic arch and 11 per cent extended beyond the aortic arch. A cervical surgical approach was performed in approximately 99 per cent of cases.

Discussion:

Thorough examination of computed tomography scans is essential in order to identify and classify substernal goitres and to decide the best surgical procedure. A cervical surgical procedure is almost always sufficient and safe for the surgical management of substernal goitres.

Conclusion:

Computed tomography appears to be the best imaging modality for identifying and characterising substernal goitres. Surgical management is almost always via a cervical approach and does not differ from that used for benign cervical goitres. In the future, magnetic resonance imaging may be used; its results would need to be compared with those of computed tomography.

Keywords

Substernal GoitreThyroidectomyComputed Tomography
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 121 , Issue 11 , November 2007 , pp. 1083 - 1087
Copyright
Copyright © JLO (1984) Limited 2007

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