Management of the substernal goiter: a team approach.
OBJECTIVE
Review the diagnosis and management of patients with substernal goiter.


METHODS
Retrospective study of a series of patients treated for substernal goiter.


METHODS
Retrospective chart review of patients with substernal goiter (N=16). Records were tabulated for demographics, symptoms, physical and CT findings as well as surgical management and comorbidities.


RESULTS
Substernal goiter occurs infrequently. Of the seventeen surgical procedures performed in these sixteen patients, only three required a median sternotomy. All of the patients had multinodular goiter. There were no instances of well differentiated thyroid cancer in this series. Co-morbidities were present in each patient.


CONCLUSIONS
Substernal goiters are often quite large at the time of diagnosis as they enlarge slowly. The majority of patients can be managed with a cervical approach. Technological advancements such as the nerve integrity monitor (NIM-2; Medtronic Xomed, Jacksonville, Florida) and Harmonic scalpel as well as team approach to surgery are advantageous for the patient.
Cannon
C Ron
CR
Head and Neck Surgical Group, 1038 River Oaks Drive, Flowood, Mississippi 39236, USA. crcannonhn@bellsouth.net
Lee
Robert
R
Didlake
Ralph
R
D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D006042:Goiter / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D012189:Retrospective Studies; D056346:Sternotomy; D013965:Thyroidectomy / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome