Substernal goitre
Updates to Article Attributes
The wordA substernal goitre is a goitre with intrathoracic extension. A goitre (or goiter) is derived from the latin word guttur, meaning throat, and is generally referred as an enlargement of the an enlarged thyroid gland.
Sub-sternal goitre : there is no clear definition, it has been considered as proposed definition is a goiter that requires mediastinal exploration and dissection for complete removal or when thean intrathoracic component appears to extendextending more than 3 cm fromin the thoracic inlet1.
Most anterior substernal thyroid goitersgoitres are accessed via a transcervical approach. For goitersgoitres that cannot be removed via neck dissection, such as those goiters with complicated anatomic extensions or posterior mediastinal involvement, the surgeon may need to incorporate a partial upper sternotomy and clavicular head resection or minithoracotomymini-thoracotomy for adequate exposure.
Radiographic assessment
According to one study
"The the most significant criteriaimportant CT features in determining the necessity of sternotomy for selecting patients requiring sternotomygoitre excision are computed tomography features, in particular the the presence of an ectopic goitre, thetotal thyroid gland volume and the extent of the goitre to orextension below the tracheal carina"3.
A potential pitfall while assessing for in the assessment of retrosternal extension is the apparent lower position thetemporarily assumed by the gland temporarily assumes ifwhen the arms are raised in the case of imaging is done on aaimed at the chest CT protocol with arms raised. This can be avoided by having the patient's arms by his/her sides whilewhen imaging for retrosternal extension 2. A surgeon who follows awith an understanding of the radiologic interpretationreporting of a substernal thyroid goiter given fromgoitre on a dedicated chest CT technique might perform a sternotomy instead of a simple low-collar incision for resection of a substernal goitergoitre.
See also
-<p>The word <strong>goitre </strong>(or<strong> goiter</strong>) is derived from the latin word <em>guttur</em>, meaning throat, and is generally referred to as an enlargement of the <a href="/articles/thyroid-gland">thyroid gland</a>.</p><p><strong>Sub-sternal goitre</strong> : there is no clear definition, but recently, it has been considered as a goiter that requires mediastinal exploration and dissection for removal or when the intrathoracic component appears to extend more than 3 cm from the thoracic inlet<sup>1</sup>.</p><p>Most anterior substernal thyroid goiters are accessed via a transcervical approach. For goiters that cannot be removed via neck dissection, such as those goiters with complicated anatomic extensions or posterior mediastinal involvement, the surgeon may need to incorporate a partial upper sternotomy and clavicular head resection or minithoracotomy for adequate exposure.</p><h4>Radiographic assessment</h4><p>According to one study</p><p>"The most significant criteria for selecting patients requiring sternotomy are computed tomography features, in particular the presence of an ectopic goitre, the thyroid gland volume and the extent of the goitre to or below the tracheal carina"<sup>3</sup></p><p>A <strong>potential pitfall</strong> while assessing for retrosternal extension is the apparent lower position the gland temporarily assumes if imaging is done on a chest CT protocol with arms raised. This can be avoided by having the patient's arms by his/her sides while imaging for retrosternal extension <sup>2. </sup>A surgeon who follows a radiologic interpretation of a substernal thyroid goiter given from a dedicated chest CT technique might perform a sternotomy instead of a simple low-collar incision for resection of a substernal goiter.</p><h4>See also</h4><ul><li><a href="/articles/fetal-goitre">fetal goitre</a></li></ul>- +<p>A <strong>substernal goitre</strong> is a goitre with intrathoracic extension. A <strong>goitre </strong>(or<strong> goiter</strong>) in general refers to an enlarged <a href="/articles/thyroid-gland">thyroid gland</a>.</p><p>It remains unclear which goitres are to be termed substernal, but a recently proposed definition is a goiter that requires mediastinal exploration and dissection for complete removal or an intrathoracic component extending more than 3 cm in the thoracic inlet <sup>1</sup>.</p><p>Most anterior substernal thyroid goitres are accessed via a transcervical approach. For goitres that cannot be removed via neck dissection, such as those with complicated anatomic extensions or posterior mediastinal involvement, the surgeon may need to incorporate a partial upper sternotomy and clavicular head resection or mini-thoracotomy for adequate exposure.</p><h4>Radiographic assessment</h4><p>According to one study the most important CT features in determining the necessity of sternotomy for goitre excision are the presence of an ectopic goitre, total thyroid gland volume and goitre extension below the tracheal carina <span style="line-height:1.6em"><sup>3</sup>.</span></p><p>A potential pitfall in the assessment of retrosternal extension is the apparent lower position temporarily assumed by the gland when the arms are raised in the case of imaging aimed at the chest. This can be avoided by having the patient's arms by his/her sides when imaging for retrosternal extension <sup>2. </sup>A surgeon with an understanding of the radiologic reporting of a substernal goitre on a dedicated chest CT might perform a sternotomy instead of a simple low-collar incision for resection of a substernal goitre.</p><h4>See also</h4><ul><li><a href="/articles/fetal-goitre">fetal goitre</a></li></ul>
Unable to process the form. Check for errors and try again.