title: Surgical management of substernal goiters: clinical experience of 170 cases.
abstract: OBJECTIVE
  To discuss the presentation, diagnosis, treatment, histopathological findings, and complications of patients who underwent thyroidectomy for substernal goiter in our surgical clinic.
  
  
  METHODS
  We retrospectively analyzed 170 patients with substernal goiters among 2650 patients undergoing surgical treatment for various thyroid diseases between 1990 and 2003. We evaluated the clinical data, preoperative diagnostic findings, surgical treatments, histopathological results, and postoperative complications.
  
  
  RESULTS
  The most common symptoms were a cervical mass (88%) and dyspnea (35%), but 26% of the patients were asymptomatic. Chest radiography provided the first evidence of a substernal goiter in 77% of the patients. We performed total or near total thyroidectomy and operated through a cervical incision in all but 12 of the patients. There was no operative mortality but 12 (7%) patients suffered temporary hypoparathyroidism and 4 suffered transient vocal cord paralysis (2%). Malignancy was diagnosed by histopathological examination in 22 (13%) patients.
  
  
  CONCLUSIONS
  We think that the diagnosis of a substernal goiter is an indication for thyroidectomy, which is associated with very low postoperative morbidity.
authors.affiliation: Department of General Surgery, Istanbul Medical Faculty, Capa 34390, Istanbul, Turkey.
authors.forename: Yesim
authors.initials: Y
authors.lastname: Erbil
authors.forename: Alp
authors.initials: A
authors.lastname: Bozbora
authors.forename: Umut
authors.initials: U
authors.lastname: Barbaros
authors.forename: Selcuk
authors.initials: S
authors.lastname: Ozarmağan
authors.forename: Adil
authors.initials: A
authors.lastname: Azezli
authors.forename: Senay
authors.initials: S
authors.lastname: Molvalilar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004417:Dyspnea / Q000209:etiology; D005260:Female; D006045:Goiter, Substernal / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000473:pathology; D011183:Postoperative Complications; D012189:Retrospective Studies; D013965:Thyroidectomy; D016896:Treatment Outcome