The surgical approach to retrosternal goiters: the role of computerized tomography

Otolaryngol Head Neck Surg. 2005 Jun;132(6):849-51. doi: 10.1016/j.otohns.2005.01.039.


Objective: To assess preoperative CT scans of patients with a retrosternal goiter, with an objective of identifying features that are likely to predict the need for sternotomy at operation.

Study design and setting: A retrospective review of clinical notes and CT scans of patients who underwent thyroidectomy for retrosternal goiter at a large district general hospital in the United Kingdom between 1998 and 2002.

Results: Extension of the goiter to the level of the aortic arch, particularly when combined with tracheal involvement or major vessel displacement, increases the likelihood of requiring median sternotomy.

Conclusions: Most retrosternal goiters can be approached through a cervical incision alone. However, extension of the goiter to the level of the aortic arch does appear to increase the likelihood of requiring sternotomy.

Significance: In such cases in which sternotomy is anticipated, the availability of cardiothoracic services would be helpful to avoid patient morbidity.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Goiter / diagnostic imaging*
  • Goiter / surgery*
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Thyroidectomy / methods*
  • Tomography, X-Ray Computed