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Related Concept Videos

The Parathyroid Glands00:59

The Parathyroid Glands

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The two pairs of parathyroid glands embedded within the posterior surface of the thyroid gland are restricted by a dense capsule around them. These glands comprise two distinct cell populations—parathyroid oxyphil and parathyroid principal cells- pivotal in calcium homeostasis.
Oxyphil cells, whose functions remain elusive, emerge during late puberty, adding a layer of complexity to the parathyroid gland's intricacies. In contrast, principal parathyroid cells undertake a vital role by...
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Related Experiment Video

Updated: Oct 15, 2025

Minimal Invasive Resection of Large Retrosternal Thyroid Goiter
04:09

Minimal Invasive Resection of Large Retrosternal Thyroid Goiter

Published on: September 20, 2024

474

Split Sternotomy in Retrosternal Thyroid and Mediastinal Parathyroid Pathologies.

Selda Gucek Haciyanli1, Serkan Karaisli1, Nihan Acar1

  • 1Department of General Surgery, Izmir Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey.

Sisli Etfal Hastanesi Tip Bulteni
|October 29, 2021
PubMed
Summary

Split sternotomy provides adequate surgical access for retrosternal goiter and mediastinal parathyroid conditions. This less invasive approach proved effective and applicable when cervical incisions alone were insufficient.

Keywords:
Mediastinal parathyroidretrosternal goitersplit sternotomy

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Area of Science:

  • Thoracic Surgery
  • Endocrine Surgery
  • Surgical Oncology

Background:

  • Cervical incisions are standard for thyroid and parathyroid pathologies.
  • Mediastinal extension of these pathologies sometimes necessitates broader surgical approaches.
  • Minimally invasive techniques are increasingly preferred over traditional median sternotomy.

Purpose of the Study:

  • To evaluate the adequacy and safety of split sternotomy for retrosternal goiter (RG) and mediastinal parathyroid pathologies.
  • To compare split sternotomy outcomes with traditional median sternotomy.

Main Methods:

  • Retrospective review of 12 patients undergoing split sternotomy between January 2010 and January 2021.
  • Inclusion criteria: retrosternal thyroid pathology or mediastinal ectopic parathyroid adenoma requiring split sternotomy.
  • Assessment of operative success, surgical exposure, and complication rates.

Main Results:

  • Split sternotomy was performed on 12 patients (mean age 57.25 years; 66.7% female).
  • Indications included multinodular goiter (25%), recurrent MNG (25%), hyperparathyroidism (25%), and thyroid cancer (25%).
  • Postoperative complications included transient hypocalcemia (50%) and unilateral vocal cord paralysis (8.3%), all resolving spontaneously. Median sternotomy was avoided in all cases.

Conclusions:

  • Split sternotomy is an adequate and applicable surgical method for retrosternal goiter and mediastinal parathyroid pathologies.
  • This approach facilitates successful excision when cervical access is insufficient, avoiding the need for median sternotomy.