title: Transclavicular access as an adjunct to standard cervical incision in the treatment of mediastinal goitre.
abstract: There are cases in which resection of cervico-mediastinal goitres requires additional thoracic access as an adjunct to standard transverse cervicotomy, and typically this takes the form of sternotomy or thoracotomy. The authors propose transclavicular access as an alternative to thoracotomy or sternotomy access for the removal of such goitres. This technical variant is performed by means of resection of the middle third of the clavicle and extraperiosteal disarticulation. They report a case of cervicomediastinal or "plunged" goitre associated with mediastinal metastasis from a follicular thyroid carcinoma in a 77-year-old woman, in whom this technical variant was used. They conclude by stressing the greater effectiveness, ease of execution and relatively limited "aggressiveness" of the technique in comparison with other ways of reaching the mediastinum. The variant proves effective in solving a number of technical, functional and aesthetic problems.
authors.affiliation: Dipartimento di Discipline Chirurgiche Generali e Speciali, U.O. di Chirurgia Generale VI, Università di Studi di Messina.
authors.forename: Claudio
authors.initials: C
authors.lastname: D'Alia
authors.forename: Agata
authors.initials: A
authors.lastname: Tonante
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Lo Schiavo
authors.forename: Filippo
authors.initials: F
authors.lastname: Taranto
authors.forename: Loretta
authors.initials: L
authors.lastname: Bonanno
authors.forename: Ettore
authors.initials: E
authors.lastname: Gagliano
authors.forename: Giovanna
authors.initials: G
authors.lastname: Di Giuseppe
authors.forename: Duilio
authors.initials: D
authors.lastname: Pagano
authors.forename: Giovanni
authors.initials: G
authors.lastname: Sturniolo
mesh_terms: D018263:Adenocarcinoma, Follicular / Q000150:complications / Q000175:diagnosis / Q000556:secondary / Q000601:surgery*; D000368:Aged; D002968:Clavicle; D003937:Diagnosis, Differential; D005260:Female; D006044:Goiter, Nodular / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D006045:Goiter, Substernal / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008479:Mediastinal Neoplasms / Q000150:complications / Q000175:diagnosis / Q000556:secondary / Q000601:surgery*; D013964:Thyroid Neoplasms / Q000150:complications; D014057:Tomography, X-Ray Computed