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Updated: Jan 9, 2026

Substernal Thyroid Biopsy Using Endobronchial Ultrasound-guided Transbronchial Needle Aspiration
Published on: November 10, 2014
Anatomical Predictors of Aerodigestive Symptoms in Substernal Goiters
Jamie Masliah1, Sushanth Neerumalla2, Abdel Metwally2
1Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA.
Background:
Substernal goiters can cause aerodigestive symptoms but are often asymptomatic. This study evaluated the relationship between symptoms, demographics, pathology, and anatomical severity in substernal goiter patients using standardized tools.
Methods:
A retrospective review of 201 patients surgically treated for substernal goiters over 11 years at a quaternary-care center was conducted. CT scan images were analyzed to measure tracheal deviation (TD), compression (TC), and depth. Symptoms included dysphagia, dyspnea, dysphonia, and coughing. Associations with demographics, anatomy, and pathology were analyzed.
Results:
Dysphagia was the most common symptom (48.8%); 27% were asymptomatic. TC and larger specimen weights were significantly associated with dyspnea (p < 0.001, 0.013). TD, depth, age, and BMI showed no significant correlation with symptoms. Cough and vocal cord dysfunction were linked to aggressive pathology (p = 0.003, 0.017).
Conclusion:
CT imaging is essential in evaluating substernal goiters, as symptoms alone are insufficient. Symptom profiles may also aid in predicting pathological severity.
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