Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
3
pubmed:dateCreated
2002-3-14
pubmed:abstractText
Patients with substernal thyroid disease, defined by the presence of enlarged thyroid tissue below the plane of the thoracic inlet, were identified from a prospective database maintained for patients who have undergone thyroidectomy at our institution since 1990. Substernal thyroid disease was present in 116 (30%) of 381 patients, anterior mediastinal in 109 (94%), and posterior mediastinal in seven (6%). Indications for surgery included compressive symptoms in 75 (65%) patients, an abnormal fine-needle biopsy in 45 (39%), progressive thyroid enlargement in 41 (35%), thyrotoxicosis in 11 (10%), and superior vena cava syndrome in two (1.7%). A median sternotomy and thoracotomy were performed in one patient each for a primary intrathoracic goiter. In all other patients thyroidectomy was accomplished through a cervical incision. Parathyroid autotransplantation was performed in 41 (37%) patients with retrosternal disease compared with 57 (22%) with disease confined to the neck (P < 0.01). Twenty-five patients (22%) had malignancy; four of these had unresectable disease. Postoperative complications included transient hypocalcemia (n = 46), transient hoarseness (n = 7), recurrent laryngeal nerve injury (n = 1), and wound infection (n = 1). One patient died from aspiration pneumonia. In summary, substernal thyroid disease is typically present in the anterior mediastinum and with rare exceptions can be resected through a cervical incision. Parathyroid devascularization is more common with resection of a substernal goiter and autotransplantation can prevent permanent hypoparathyroidism.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:status
MEDLINE
pubmed:month
Mar
pubmed:issn
0003-1348
pubmed:author
pubmed:issnType
Print
pubmed:volume
68
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
245-51; discussion 251-2
pubmed:dateRevised
2006-11-15
pubmed:meshHeading
pubmed-meshheading:11893102-Adolescent, pubmed-meshheading:11893102-Adult, pubmed-meshheading:11893102-Aged, pubmed-meshheading:11893102-Aged, 80 and over, pubmed-meshheading:11893102-Child, pubmed-meshheading:11893102-Female, pubmed-meshheading:11893102-Follow-Up Studies, pubmed-meshheading:11893102-Goiter, Nodular, pubmed-meshheading:11893102-Goiter, Substernal, pubmed-meshheading:11893102-Humans, pubmed-meshheading:11893102-Male, pubmed-meshheading:11893102-Middle Aged, pubmed-meshheading:11893102-Postoperative Complications, pubmed-meshheading:11893102-Probability, pubmed-meshheading:11893102-Prospective Studies, pubmed-meshheading:11893102-Registries, pubmed-meshheading:11893102-Risk Assessment, pubmed-meshheading:11893102-Severity of Illness Index, pubmed-meshheading:11893102-Thyroidectomy, pubmed-meshheading:11893102-Tomography, X-Ray Computed, pubmed-meshheading:11893102-Treatment Outcome
pubmed:year
2002
pubmed:articleTitle
The clinical presentation and operative management of nodular and diffuse substernal thyroid disease.
pubmed:affiliation
Department of Surgery, MetroHealth Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio 44109-1998, USA.
pubmed:publicationType
Journal Article, Comparative Study