title: Diagnosis and management of substernal goiter at the University of Crete.
abstract: The objective of this work was to evaluate the diagnosis and management of patients with substernal goiter (SSG) on the basis of our experience. We conducted a retrospective study of all SSGs within a series of 591 thyroidectomies performed in a tertiary referral center over a period of 14 years, analyzing epidemiological data, diagnostic criteria, and surgical results. There were 37 (6%) patients with descending goiter: 28 women (mean age 57.1 years) and 9 men (mean age 61 years). All 37 patients underwent successful surgical treatment without any major postoperative complications. A postoperative histological examination revealed a 16.6% incidence of malignancy. Despite the size and close proximity to vital organs in the mediastinum, all of the SSGs were managed successfully. A neck approach was used in all except for one patient who was operated on via sternotomy. A thorough preoperative evaluation including computed tomography scan of the neck and mediastinum, and an appropriate surgical technique ensure a positive outcome for most patients with an SSG.
authors.affiliation: Department of Otolaryngology, University of Crete School of Medicine, Heraklion, Crete, Greece.
authors.forename: John
authors.initials: J
authors.lastname: Bizakis
authors.forename: Alexandros
authors.initials: A
authors.lastname: Karatzanis
authors.forename: Jiannis
authors.initials: J
authors.lastname: Hajiioannou
authors.forename: Constantinos
authors.initials: C
authors.lastname: Bourolias
authors.forename: Eleutherios
authors.initials: E
authors.lastname: Maganas
authors.forename: Elias
authors.initials: E
authors.lastname: Spanakis
authors.forename: Argyro
authors.initials: A
authors.lastname: Bizaki
authors.forename: George
authors.initials: G
authors.lastname: Velegrakis
mesh_terms: D005260:Female; D006045:Goiter, Substernal / Q000175:diagnosis* / Q000601:surgery*; D006115:Greece; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013965:Thyroidectomy