title: Surgical management of the substernal thyroid gland.
abstract: From 1992 to 1996, 19 patients had surgical resection of a substernal thyroid gland at the University of Rochester Medical Center, Rochester, New York. Based on a retrospective review of the 21 procedures performed, an algorithm for evaluation and surgical intervention is proposed. A limited medical workup is indicated and consists of a chest x-ray, thyroid function tests, computed tomography scan, and, possibly, fine-needle aspiration. Given a modestly high malignancy rate (16%) and a 37% reoperative rate, total thyroidectomy should be performed. When extensive mediastinal disease is encountered, a median sternotomy affords excellent access to the substernal thyroid gland.
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, University of Rochester Medical Center, New York 14642, USA.
authors.forename: R S
authors.initials: RS
authors.lastname: Pulli
authors.forename: J U
authors.initials: JU
authors.lastname: Coniglio
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006042:Goiter / Q000145:classification / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D013961:Thyroid Gland / Q000601:surgery; D013965:Thyroidectomy / Q000379:methods; D016896:Treatment Outcome