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Sternotomy for substernal goitre: an otolaryngologist's perspective

Published online by Cambridge University Press:  11 July 2007

P Burns ,
J Doody  and
C Timon
P Burns*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, St James's Hospital, Dublin, Ireland
J Doody
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, St James's Hospital, Dublin, Ireland
C Timon
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, St James's Hospital, Dublin, Ireland
*
Address for correspondence: Mr Paul Burns, 31 Woodview, Mount Merrion Ave, Blackrock, Co Dublin, Ireland. E-mail: pauljburns@eircom.net
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Abstract

Introduction:

Large substernal goitres present a challenge to the otolaryngologist due to their size and location. Predicting which patients will require sternotomy can enable planning of surgery in a specialist centre, with the assistance of a thoracic surgeon. Our aim for this study was to establish clinical and radiological predictors which would aid the otolaryngologist in the pre-operative planning of such cases.

Methods:

A retrospective medical record review was conducted for all patients undergoing thyroidectomy for substernal goitre who required sternotomy in our institution over a 10-year period.

Results:

During the study period, 140 patients with substernal goitres underwent thyroidectomy. Three patients (2 per cent) required sternotomy. These cases are described.

Conclusions:

Radiological evidence of extension of a substernal goitre to the aortic knuckle, or loss of tissue planes on computed tomography, should raise suspicion that the patient may require sternotomy for safe delivery of the gland. The otolaryngologist should plan surgery for these patients in a specialist centre, with the help of a thoracic surgeon.

Keywords

Substernal GoitreSternotomyThyroidectomyMediastinum
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 5 , May 2008 , pp. 495 - 499
Copyright
Copyright © JLO (1984) Limited 2007

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Footnotes

Presented at the Royal Academy of Medicine in Ireland Otolaryngology Spring Meeting, 30 and 31 March 2007, Cork, Ireland.

References

1 Katlic, MR, Grillo, HC, Wong, C. Substernal goitre: analysis of 80 patients from Massachusetts General Hospital. Am J Surg 1985;149:283–7CrossRefGoogle ScholarPubMed
2 Newman, E, Shaha, AR. Substernal goitre. J Surg Oncol 1995;60:207–12CrossRefGoogle Scholar
3 Pandya, S, Sanders, LE. Use of a foley catheter in the removal of a substernal goitre. Am J Surg 1998;175:155–7CrossRefGoogle Scholar
4 Ahmed, ME, Elnazeer, OA, Mahadi, SI. Retrosternal goitre: the need for median sternotomy. W J Surg 2006;30:1945–8CrossRefGoogle ScholarPubMed
5 Gough, I. Invited commentary on retrosternal goitre: the need for median sternotomy. W J Surg 2006;30:1949CrossRefGoogle Scholar
6 Hashmi, SM, Premachandra, DJ, Bennett, AMD, Parry, W. Management of retrosternal goitres: results of early surgical intervention to prevent airway morbidity, and a review of the English literature. J Laryngol Otol 2006;120:644–9CrossRefGoogle Scholar
7 Wheeler, MH. Clinical dilemma: retrosternal goitre. Br J Surg 1999;86:1235–6CrossRefGoogle ScholarPubMed
8 Cho, HT, Cohen, JP, Som, ML. Management of substernal and intrathoracic goitres. Otolaryngol Head Neck Surg 1986;94:282–7CrossRefGoogle Scholar
9 Michael, LA, Bradpiece, HA. Surgical management of substernal goitre. Br J Surg 1988;75:565–9CrossRefGoogle Scholar
10 Torre, G, Borgonovo, G, Amato, A, Azezzo, A, Ansaldo, G. Surgical management of substernal goitre: analysis of 237 patients. Am J Surg 1995;61:826–31Google ScholarPubMed
11 Hedayati, N, McHenry, CR. The clinical presentation and operative management of nodular and diffuse substernal thyroid disease. Am J Surg 2002;68:245–53CrossRefGoogle ScholarPubMed
12 Netterville, JL, Coleman, SC, Smith, JC, Michelle, M, Day, TA, Burkey, BB. Management of substernal goitre. Laryngoscope 1998;108:1611–17CrossRefGoogle Scholar