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Cervicothoracic goitre: an anatomical or radiological definition? Report of 223 surgical cases

Published online by Cambridge University Press:  15 March 2007

C Page  and
V Strunski
C Page*
Affiliation:
Anatomy Department, School of Medicine, ‘Jules Verne’ University, Amiens, France ENT and Head and Neck Surgery Department, University Hospital of Amiens, France.
V Strunski
Affiliation:
Anatomy Department, School of Medicine, ‘Jules Verne’ University, Amiens, France
*
Address for correspondence: Dr Cyril Page, Centre Hospitalier Nord, Place Victor Pauchet, 80054 Amiens cedex, France. Fax: 03 22 66 86 23 E-mail: cyril_page@yahoo.fr
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Abstract

Objectives:

To analyse and compare chest radiographs and cervicothoracic computed tomography scans taken prior to thyroid surgery, in order to locate and predict thoracic extension of substernal goitres.

Method:

This eight-year, retrospective study included 223 patients who had undergone total thyroidectomy for benign, substernal, multinodular goitres. Chest radiographs and computed tomography scans were reviewed by two physicians (a senior ENT surgeon and a senior radiologist).

Results:

The most frequent mode of extension was anterior or prevascular, seen in 76 per cent of cases, especially on the left side. Fifty-nine per cent of goitres did not reach the aortic arch and 11 per cent extended beyond the aortic arch. A cervical surgical approach was performed in approximately 99 per cent of cases.

Discussion:

Thorough examination of computed tomography scans is essential in order to identify and classify substernal goitres and to decide the best surgical procedure. A cervical surgical procedure is almost always sufficient and safe for the surgical management of substernal goitres.

Conclusion:

Computed tomography appears to be the best imaging modality for identifying and characterising substernal goitres. Surgical management is almost always via a cervical approach and does not differ from that used for benign cervical goitres. In the future, magnetic resonance imaging may be used; its results would need to be compared with those of computed tomography.

Keywords

Substernal GoitreThyroidectomyComputed Tomography

Information

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 121 , Issue 11 , November 2007 , pp. 1083 - 1087
Copyright
Copyright © JLO (1984) Limited 2007

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References

1Maruotti, RA, Zannini, P, Viani, MP, Voci, C, Pezzuoli, G. Surgical treatment of substernal goitres. Int Surg 1991;76:12–7Google Scholar
2Hili, JL, Mayer, G, Carini, L, Cantelli, G, Modigliani, U. Cervico-mediastinal goitre. Analysis of preoperative clinical symptoms. Minerva Chir 1993;48:533–7Google ScholarPubMed
3Netterville, JL, Coleman, SC, Smit, JC, Smith, MM, Day, TA, Burkey, BB. Management of substernal goitre. Laryngoscope 1998;108:1611–17CrossRefGoogle Scholar
4Siragusa, G, Gelarda, E, Geraci, G, Albanese, L, Di Pace, G. Cervico-mediastinal goitre. Our experience. Minerva Chir 1999;54:225–9Google ScholarPubMed
5Sianesi, M, Del Rio, P, Arcuri, MF, Soliani, P, Rusca, M. Cervico-mediastinal goitre. Chir Ital 2002;54:15–18Google Scholar
6Erbil, Y, Bozbora, A, Barbaros, U, Ozarmagan, S, Azezli, A, Molvalilar, S. Surgical management of substernal goitres: clinical experience of 170 cases. Surg Today 2004;34:732–6CrossRefGoogle ScholarPubMed
7Flati, G, De Giacomo, T, Porowska, B, Flati, D, Gaj, F, Talarico, C et al. Surgical management of substernal goitres. When is sternotomy inevitable? Clin Ter 2005;156:191–5Google ScholarPubMed
8Borrely, J, Grosdidier, G, Hubert, J. Precise classifications of substernal goitres: report of 112 cases [in French]. Ann Chir Chir Thorac Cardio-vasc 1985;39:153–9Google Scholar
9Blondeau, P. Substernal goiter: diagnostic and therapeutic problems. Acad Nat Med 1994;178:1257–64Google ScholarPubMed
10Vadasz, P, Kotsis, L. Surgical aspects of 175 mediastinal goitres. Eur J Cardiothorac Surg 1998;14:393–7CrossRefGoogle Scholar
11Hedayati, N, McHenry, CR. The clinical presentation and operative management of nodular and diffuse substernal thyroid disease. Am Surg 2002;63:245–51CrossRefGoogle Scholar
12Torre, G, Borgonovo, G, Amato, A, Arezzo, A, Ansaldo, G, De Negri, A, Ughe, M, Mattioli, F. Surgical management of substernal goiter: analysis of 237 patients. Am Surg 1995;61:826–31Google ScholarPubMed
13Al-Suliman, NN, Graversen, HP, Blichert-Toft, M. Intrathoracic goiter. Diagnostic aspects, surgical complications and permanent sequelae [in Danish]. Ugeskr Laeger 1994;156:1646–9Google ScholarPubMed
14Belardinelli, L, Gualdi, G, Ceroni, L, Guadalaxara, A, Polettini, E, Pappalardo, G. Comparison between computed tomography and magnetic resonance data and pathologic findings in substernal goiters. Int Surg 1995;80:65–9Google ScholarPubMed
15Rodriguez, JM, Hernandez, Q, Pinero, A, Ortiz, S, Soria, T, Ramirez, P et al. Substernal goiter: clinical experience of 72 cases. Ann Otol Rhinol Laryngol 1999;108:501–4Google ScholarPubMed