Sternotomy for substernal goitre: an otolaryngologist's perspective

Area of Science:

• Otolaryngology
• Thoracic Surgery
• Radiology

Background:

• Large substernal goitres pose surgical challenges due to size and location.
• Pre-operative prediction of sternotomy requirement aids surgical planning.
• Multidisciplinary team involvement, including thoracic surgeons, is often necessary.

Observation:

• A retrospective review of 140 thyroidectomy cases for substernal goitre over 10 years was performed.
• Three patients (2%) required sternotomy for substernal goitre removal.
• Specific clinical and radiological factors were analyzed to identify predictors of sternotomy.

Findings:

• Computed tomography (CT) findings of substernal goitre extension to the aortic knuckle predict sternotomy.
• Loss of tissue planes on CT scans is another indicator for potential sternotomy.
• These radiological signs suggest the need for sternotomy for safe gland delivery.

Implications:

• Otolaryngologists should consider sternotomy in patients with specific CT findings of substernal goitre.
• Pre-operative planning with thoracic surgeons is recommended for these high-risk cases.
• This approach enhances surgical safety and optimizes patient outcomes for complex substernal goitres.