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Related Experiment Video

Updated: Jul 5, 2025

Substernal Thyroid Biopsy Using Endobronchial Ultrasound-guided Transbronchial Needle Aspiration
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Extracervical Approaches to Substernal Thyroid Goiter Resection: A Systematic Review and Meta-Analysis.

Najm S Khan1, Yingting Zhang2, Kassie Bollig3

  • 1Department of Otolaryngology-Head and Neck Surgery Rutgers Robert Wood Johnson Medical School New Brunswick New Jersey USA.

OTO Open
|January 15, 2024
PubMed
Summary

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Extracervical approaches (ECAs) are rarely needed for substernal goiter (SSG) excision, occurring in approximately 6% of cases. Patients should be informed about the potential need for ECAs during surgical counseling.

Area of Science:

  • Surgery
  • Endocrinology
  • Thoracic Surgery

Background:

  • Substernal goiter (SSG) excision can be complex, sometimes requiring approaches beyond the neck.
  • Extracervical approaches (ECAs) involve sternotomy or thoracotomy for SSG removal.
  • Understanding the prevalence of ECAs is crucial for surgical planning and patient counseling.

Purpose of the Study:

  • To determine the prevalence of extracervical approaches (ECAs) used in the surgical excision of substernal goiter (SSG).
  • To analyze ECA prevalence based on different definitions of SSG extent.

Main Methods:

  • A systematic literature search was conducted across multiple databases (PubMed, Cochrane, Scopus, Web of Science, Google Scholar) up to July 2021.
  • Included studies involved adult patients undergoing SSG excision.
Keywords:
extracervical approachesgoiterretrosternalsternotomysubsternalthoracotomy

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  • Data were extracted from 69 studies, categorizing SSG based on three distinct definitions of descent.

    • Main Results:

    • The most common definition of SSG involved extension below the thoracic inlet.
    • Across 31 studies using this definition, the pooled prevalence of ECA was 6.12%.
    • Analysis included data from over 9,000 patients across the different definitions.

    Conclusions:

    • The definition of SSG extending below the thoracic inlet is most frequently applied.
    • Approximately 6% of patients with SSG require an extracervical approach during surgery.
    • Patients undergoing SSG surgery must be counseled regarding the risks and prevalence of ECAs.