title: A critical analysis of 33 patients with substernal goiter surgically treated by neck incision.
abstract: The possibility of needing a combined access, with neck and chest incisions makes the treatment of substernal goiter a challenge both in the pre-op and the intraoperative. We hereby, discuss a standardization of the surgical technique to minimize the need for a chest approach, making the substernal goiter a surgically treatable disease, through a single neck incision, and with low indices of complication.
  
  
  OBJECTIVE
  To assess the substernal goiter surgically approach through a neck incision and to analyze the surgical complications.
  
  
  METHODS
  We carried out a historical cohort by retrospective analysis of the charts of patients submitted to thyroidectomy, and 33 of them (10.4%) had substernal goiter.
  
  
  RESULTS
  All 33 patients were surgically treated through a neck incision without the need for sternotomy. We did not observe definitive lesions in the inferior laryngeal nerve or definitive hypoparathyroidism. Only 2 patients had recurrent nerve paresis; and 2 patients were re-operated because of a neck hematoma.
  
  
  CONCLUSIONS
  Patients with substernal goiter can be safely treated surgically through a single neck incision, bearing low complication rates.
authors: Head and Neck Surgery Program, UNIFESP.
authors: Murilo Catafesta Das
authors: MC
authors: Neves
authors: Marcello
authors: M
authors: Rosano
authors: Flávio Carneiro
authors: FC
authors: Hojaij
authors: Márcio
authors: M
authors: Abrahão
authors: Onivaldo
authors: O
authors: Cervantes
authors: Danielle Macellaro
authors: DM
authors: Andreoni
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006045:Goiter, Substernal / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis; D012189:Retrospective Studies