title: [Assessment and surgical treatment for 58 substernal goiter].
abstract: Objective:To investigate the diagnosis and treatment of substernal goiter.Methods:A total of 58 cases with substernal goiters undergoing surgery between January 2005 and December 2015 were analysed retrospectively. There were 10 males and 48 females and their age ranged from 38 to 82 years with a median age of 58 years. According to enhanced CT and clinical signs of substernal goiters, there were 40 cases for typeⅠ, 17 cases for type Ⅱ, and 1 case for type Ⅲ.Results:Patients with typeⅠand Ⅱ substernal goiters (8 cases of papillary carcinoma) underwent low neck and collar-type incision, and patients with type Ⅲ substernal goiters received carotid chest surgery. The use of harmonic scalpel in sternal goiter surgery provided with clearer surgical field, less bleeding. All the operations were successful, and recurrent laryngeal nerve was visually identified in all patients. Postoperative complications included trachyphonia (2 cases), without difficult breathing and tracheal stenosis.Conclusions:Enhanced CT is the best means of preoperatively assessment of substernal goiter. It is feasible to treat patients with typeⅠand Ⅱ substernal goiters by lower neck and collar-type incision. Use of harmonic scalpel in substernal goiter surgery can reduce operation time and bleeding.
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, Zhongda Hospital, Southeast University, Nanjing 210009, China.
authors.forename: X
authors.initials: X
authors.lastname: Zhu
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, Zhongda Hospital, Southeast University, Nanjing 210009, China.
authors.forename: Z C
authors.initials: ZC
authors.lastname: Huang
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, Zhongda Hospital, Southeast University, Nanjing 210009, China.
authors.forename: X
authors.initials: X
authors.lastname: Feng
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, Zhongda Hospital, Southeast University, Nanjing 210009, China.
authors.forename: F
authors.initials: F
authors.lastname: Tao
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002291:Carcinoma, Papillary / Q000000981:diagnostic imaging* / Q000601:surgery*; D004417:Dyspnea; D005260:Female; D006045:Goiter, Substernal / Q000145:classification / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck; D011183:Postoperative Complications / Q000145:classification; D012009:Recurrent Laryngeal Nerve; D012189:Retrospective Studies; D013525:Surgical Instruments; D014057:Tomography, X-Ray Computed; D014135:Tracheal Stenosis / Q000209:etiology
keywords: Goiter, substernal; Harmonic scalpel; Surgical procedures, operative