title: Predictive value of thyroid tissue density in determining the patients on whom sternotomy should be performed.
abstract: BACKGROUND
  Retrosternal goiter incidence rates range between 0.2% and 45% of all goiters, and sternotomy is performed in some of patients. There is no consensus for selecting the patients on whom sternotomy should be performed. We aimed to determine the most important factor for predicting requirement of sternotomy.
  
  
  METHODS
  This prospective study included 260 patients with retrosternal goiter. The clinical symptoms, history of previous thyroidectomy, presence of tracheal deviation, tracheal compression, site of mediastinal extension, thyroid tissue density, findings of intubation, type of surgical approach, histologic findings of thyroid, weight of thyroid, and postoperative complications were evaluated.
  
  
  RESULTS
  Thyroid tissue density, posterior location, and subcarinal extension were found to be independent factors for predicting requirement of sternotomy. The risk for sternotomy increased 47-fold for patients with harder thyroid tissue density (OR: 47.3; 95% CI: 5.8-385.70), 20-fold for patients with subcarinal extension (OR: 20.5; 95% CI: 2.5-168), and 10-fold for patients with posterior location (OR: 10.5; 95% CI:1.8-60).
  
  
  CONCLUSIONS
  Thyroid tissue density was defined the strongest predictive factor for requirement of sternotomy. Preoperatively obtained information thyroid tissue density can be useful for surgical strategy.
authors: Department of General Surgery, Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey.
authors: Serkan
authors: S
authors: Sari
authors: Yeşim
authors: Y
authors: Erbil
authors: Feyzullah
authors: F
authors: Ersöz
authors: Gülay
authors: G
authors: Saricam
authors: Artür
authors: A
authors: Salmaslioğlu
authors: Halim
authors: H
authors: Işsever
authors: Selçuk
authors: S
authors: Ozarmağan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005544:Forecasting; D006042:Goiter / Q000473:pathology / Q000601:surgery*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D056346:Sternotomy; D013961:Thyroid Gland / Q000473:pathology*