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Management of substernal goitre
1Department of Otolaryngology, Head and Neck Surgery, University of Toronto, Ontario, Canada.
The Journal of Otolaryngology
|June 1, 1992
Summary
Substernal goitres, unlike neck goitres, often cause compression symptoms and require surgery. This study reviews 938 thyroid surgeries, finding substernal goitres in 2.4% of cases, highlighting their distinct management needs.
Area of Science:
- Endocrinology
- Surgical Oncology
- Head and Neck Surgery
Background:
- Substernal goitres present differently than cervical goitres.
- They often cause tracheal or esophageal compression symptoms.
- Unlike cervical goitres, substernal goitres do not respond to medical suppression.
Purpose of the Study:
- To compare the presentation and management of substernal goitres versus cervical goitres.
- To analyze the surgical outcomes for patients with substernal goitres.
- To determine the incidence of substernal goitres in patients undergoing thyroid surgery.
Main Methods:
- Retrospective chart review of 938 patients undergoing thyroid surgery.
- Data collected from the Head and Neck Tumour Registry at the University of Toronto.
- Analysis of patient history, pathology, and surgical management.
Main Results:
- Substernal goitres were identified in approximately 2.4% of the study cohort.
- Symptoms related to tracheal or esophageal compression were common.
- Surgical intervention was necessary for all substernal goitres.
Conclusions:
- Substernal goitres necessitate distinct diagnostic and management strategies.
- The trans-cervical surgical approach is preferred, with potential need for thoracic extension.
- Accurate patient history is crucial for identifying substernal goitres, even in asymptomatic individuals.