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. 2024 Feb;44(1):21-26.
doi: 10.14639/0392-100X-N2746.

Extended cervical approach for retrosternal multinodular goiter

Nir Tsur  1   2 , Lirit Levi  1   2 , Omry Frig  1   2 , Noam Koch  1 , Yossi Eshel  1   2 , Gideon Bachar  1   2 , Thomas Shpitzer  1   2 , Moshe Yehuda  1   2 , Yuri Pescovitz  2   3 , Ory Wiesel  2   3 , Dean Dudkiewicz  1   2 , Aviram Mizrachi  1   2
Affiliations

Extended cervical approach for retrosternal multinodular goiter

Nir Tsur et al. Acta Otorhinolaryngol Ital. 2024 Feb.

Abstract

Objective: Partial or total sternotomy is required for 10% of retrosternal goiter. This study reviewed our experience with an extended cervicotomic approach as an alternative surgical solution for retrosternal goiter.

Methods: A retrospective study was performed on patients who underwent partial or total thyroidectomy for retrosternal goiter between 2014 and 2019 at a tertiary medical centre. Data on clinical, radiologic, and pathologic factors were analysed. Peri- and postoperative outcomes were compared between extended and standard cervical approaches to predict the need for an extended cervical approach.

Results: The cohort included 265 patients, of whom 245 (92.4%) were treated by standard thyroidectomy. In 17 (6.4%), the standard approach proved insufficient, and the horizontal incision was extended to a T-shape to improve access. The remaining 3 patients required a sternotomy. Use of the extended cervical approach was significantly associated with clinical features such as male gender, diabetes, high body mass index and postoperative hypocalcaemia.

Conclusions: The extended cervicotomic approach is an alternative surgical solution for retrosternal goiter, with no increased risk of significant post-operative complications.

Keywords: cervicotomy; extended approach; hypoparathyroidism; retrosternal goiter; sternotomy.

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Conflict of interest statement

The authors declare no conflict of interest.

This research did not receive any specific grant from fund-ing agencies in the public, commercial, or not-for-profit sectors.

Figures

Figure 1.
Figure 1.
The extended cervical approach; a transverse collar and a midline incision to the sternal notch.
See this image and copyright information in PMC

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