title: Adaptation of median partial sternotomy in head and neck surgery.
abstract: Upper mediastinum involvement in diseases of the head and neck may require a sternal split. This study describes our adaptation of the upper median or "minimal" sternotomy technique for the treatment of head and neck pathologies. Between April 2002 and October 2005, 17 patients aged 4 to 82 years underwent minimal sternotomy in our institution for a variety of head and neck pathologies. The 17 patients included 11 adults with metastatic thyroid disease (six metastatic papillary thyroid carcinoma, two medullary carcinoma, and one Hiirthle cell carcinoma) and huge retrosternal goiter (n = 2), four adults with parathyroid disease (two primary parathyroid adenoma, one secondary hyperplasia, and one parathyroid carcinoma), and two children with lymphangioma and huge thymic cyst (one each). Average hospitalization was 8 days. Four patients needed a thoracic drain for 2 days, one had recurrent laryngeal nerve palsy, and one had phrenic nerve paresis. There were no postoperative deaths. Minimal sternotomy appears to be an excellent alternative for surgical exploration of the mediastinum and may be used in head and neck surgery for a range of indications.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Rabin Medical Center, Beilinson Campus, Petah Tikvah, Israel. thomas-s@zahav.net.il
authors.forename: Thomas
authors.initials: T
authors.lastname: Shpitzer
authors.forename: Milton
authors.initials: M
authors.lastname: Saute
authors.forename: Hanna
authors.initials: H
authors.lastname: Gilat
authors.forename: Eyal
authors.initials: E
authors.lastname: Raveh
authors.forename: Ilan
authors.initials: I
authors.lastname: Koren
authors.forename: Jacob
authors.initials: J
authors.lastname: Shvero
authors.forename: Gideon
authors.initials: G
authors.lastname: Bahar
authors.forename: Raphael
authors.initials: R
authors.lastname: Feinmesser
mesh_terms: D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006042:Goiter / Q000473:pathology / Q000601:surgery; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000601:surgery; D006801:Humans; D007902:Length of Stay; D008297:Male; D008477:Mediastinal Diseases / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D012189:Retrospective Studies; D013249:Sternum / Q000601:surgery*; D013908:Thoracotomy / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome