Background and Objectives: Substernal goiter, defined as any thyroid enlargement that has greater mass inferior to the thoracic inlet, is a relatively rare disease with a potential for malignancy and the risk of postoperative airway
obstruction
secondary to tracheomalacia. We investigated clinical characteristics of substernal goiters and anlyzed the results of the treatment to establish modalities of the surgical management. Materials and Methods: We examined, retrospectively,
ten
cases of substernal goiters and reviewed their clinical features, radiolgical findings, histopathologic findings, operative findings and postoperative complications. Results: We found tracheal deviations in six patients, tracheomalacia in
three
patients and calcification in two patients. We performed partial thyroidectomy for 9 cases and total thyroidectomy and superior mediastinal dissection were done for a case which revealed to be follicular carcinoma. The main histopathologic
findings
were
multinodular goiter in five cases, followed by follicular adenoma, and follicular carcinoma in one case. Endotracheal intubation was removed after 24 hours postoperatively for six cases who showed severe tracheal compression and tracheal
deviation
and
the trachopexy (tracheal suspension) to the sternum was performed for one case among them. Conclusion: Because of the possibilities of malignancy and the acute airway obstruction, the surgical treatment and careful postoperative airway
management
should be emphasized for substernal goiter.
|