Surgical treatment of substernal goiter: analysis of 102 patients

Objective To summarize surgical experience for the treatment of substernal goiter. Methods 102 cases of substernal goiter underwent surgical resection, in 74 by low collar incision, 12 cases by larger low collar incision and pillowing the shoulder pad about 20 degrees for neck hyperextension, 8 cases by unilateral or bilateral infrahyoid muscles transection, 8 cases by low collar and up-mid-sternal incision plus horizontal sawing in 2 and 3 ribs. Results Resection was performed successfully in all cases. Hoarseness occurred in 7 cases, 4 cases recovered after one month, 3 cases did not improve because of tumor invasion of laryngeal recurrent nerve. Postoperative transient hypocalcemia in 9 cases recovered after 2 to 3 months. 102 patients were followed up for 1 to 3 years without recurrence. Conclusions Substernal goiter can be resected successfully through a transcervical approach or mid-sternal incision. CT scanning and chest X radiograph are decisive for the surgical approach. Key words: Goiter, substernal; Diagnosis; Thyroidectomy