title: Substernal goiter: Experience with 50 cases.
abstract: BACKGROUND
  Goiter is localized or generalized thyroid hypertrophy. It is usually cervical, but may show intra-thoracic development beyond the thoracic inlet and down to the mediastinum: i.e., substernal goiter. The purpose of this study was to analyze the epidemiological, clinical and paraclinical profile of substernal goiter and the difficulties of management.
  
  
  METHODS
  A retrospective study included 50 cases from our ENT department.
  
  
  RESULTS
  Mean age was 47 years, with a sex ratio of 0.06. Clinical symptomatology was dominated by medial anterior cervical swelling. Compression signs were observed in 26 patients, and cervical lymph nodes in 3. Mean time to consultation was 7 years. Fiberoptic endoscopy found vocal cord palsy in 3 patients. Cervical ultrasonography was the first-line diagnostic test. Cervical-thoracic CT scan was requested in 45 patients to study thoracic extension and the relation of the thyroid mass with the supra-aortic vascular axes. Treatment systematically comprised total thyroidectomy on a cervical approach. There were 6 cases of malignancy.
  
  
  CONCLUSIONS
  Substernal goitre is fairly frequent. Despite particularities, an exclusively cervical approach is sufficient in a large majority of cases. The substernal nature of the goitre did not have major impact on postoperative complications.
authors.affiliation: Service d'ORL et de chirurgie cervico-faciale, hôpital 20 Août, CHU Ibn-Rochd, Casablanca, Morocco. Electronic address: dr.benbakh.m@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Benbakh
authors.affiliation: Service d'ORL et de chirurgie cervico-faciale, hôpital 20 Août, CHU Ibn-Rochd, Casablanca, Morocco.
authors.forename: M
authors.initials: M
authors.lastname: Abou-elfadl
authors.affiliation: Service d'ORL et de chirurgie cervico-faciale, hôpital 20 Août, CHU Ibn-Rochd, Casablanca, Morocco.
authors.forename: S
authors.initials: S
authors.lastname: Rouadi
authors.affiliation: Service d'ORL et de chirurgie cervico-faciale, hôpital 20 Août, CHU Ibn-Rochd, Casablanca, Morocco.
authors.forename: R-L
authors.initials: RL
authors.lastname: Abada
authors.affiliation: Service d'ORL et de chirurgie cervico-faciale, hôpital 20 Août, CHU Ibn-Rochd, Casablanca, Morocco.
authors.forename: M
authors.initials: M
authors.lastname: Roubal
authors.affiliation: Service d'ORL et de chirurgie cervico-faciale, hôpital 20 Août, CHU Ibn-Rochd, Casablanca, Morocco.
authors.forename: M
authors.initials: M
authors.lastname: Mahtar
mesh_terms: D000328:Adult; D000368:Aged; D004487:Edema / Q000209:etiology; D004724:Endoscopy; D005260:Female; D006045:Goiter, Substernal / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009018:Morocco / Q000453:epidemiology; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000453:epidemiology; D013965:Thyroidectomy; D014826:Vocal Cord Paralysis / Q000209:etiology; D055815:Young Adult
keywords: CT; Fiberoptic endoscopy; Goiter; Substernal; Surgery