[Intrathoracic goiter. Diagnostic aspects, surgical complications and permanent sequelae]

During the course of 1151 thyroidectomies performed during an 11-year period, 195 patients were found to have intrathoracic goitre. Centre experience of operating this disease and the usefulness of applied diagnostic methods are analysed. The sensitivity of physical examination (palpation), technetium scintigraphy and chest roentgenogram is respectively 52%, 33% and 65%, while specificity is respectively 99%, 98% and 95%. These three methods together ensure the diagnosis in 82% of the patients. Positive predictive values are respectively 95%, 78%, and 72%, while negative predictive values are found to be 91%, 89%, and 93%. Frequency of permanent unilateral vocal cord paresis is 2.5%, no cases of bilateral recurrent nerve damage occurred. The frequency of unilateral vocal cord paresis is found to be 1.4%, if nerves of risk are considered. The incidence of hypocalcemia requiring permanent treatment reaches 2%. Intrathoracic goitre can be treated surgically with an only slightly elevated risk for surgical complications and permanent sequelae, especially when performed in the elective phase and within the frame of centre facilities. Intrathoracic components can nearly always (97%) be reached through cervical incision.