Surgery of Retrosternal Thyroid: Evaluation of 36 Cases

Objective: Retrosternal thyroid is the presence of thyroid tissue in the mediastinum either by enlarging of the cervical or by an ectopic mediastinal thyroid. Surgery for a retrosternal thyroid has technical differences than conventional cervical thyroid surgery and has a higher risk of complication...

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Main Authors: Alperen Vural, Emrah Gülmez, Ömer Faruk Demir, Kerem Kökoğlu, Imdat Yüce, Sedat Çağlı
Format: Article
Language:English
Published: KARE Publishing 2019-09-01
Series:Erciyes Medical Journal
Subjects:
Online Access:https://jag.journalagent.com/z4/download_fulltext.asp?pdir=erciyesmedj&un=EMJ-37542
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author Alperen Vural
Emrah Gülmez
Ömer Faruk Demir
Kerem Kökoğlu
Imdat Yüce
Sedat Çağlı
author_facet Alperen Vural
Emrah Gülmez
Ömer Faruk Demir
Kerem Kökoğlu
Imdat Yüce
Sedat Çağlı
author_sort Alperen Vural
collection DOAJ
description Objective: Retrosternal thyroid is the presence of thyroid tissue in the mediastinum either by enlarging of the cervical or by an ectopic mediastinal thyroid. Surgery for a retrosternal thyroid has technical differences than conventional cervical thyroid surgery and has a higher risk of complications. This paper aims to analyze the cases with retrosternal thyroid and to evaluate the outcomes of the surgery. Materials and Methods: Retrospective analysis in terms of age, sex, clinical course, thyroid hormone levels, parathormone (PTH) levels, diagnostic methods, and fine needle aspiration cytology (FNAC) results and complications of 36 cases that underwent surgery was performed. Results: In addition to routine evaluation for thyroid pathology, computerized tomography was used for each patient. Thirty-four surgeries were completed with a cervical incision, one with a sternotomy and one with a thoracotomy. Four patients (11.1%) experienced temporary postoperative hypocalcemia, and one patient had a transient vocal cord immobility. Neither permanent hypocalcemia nor vocal cord paralysis was present in any of the patients postoperatively. Conclusion: Planning surgery as early as possible is suggested to avoid compression symptoms and possible malignancy. Cervical approach is mostly enough for the majority of patients; however, in case of a need of an additional (transthoracic) approach, multidisciplinary planning with thoracic surgeons is proposed. The risk of complications in experienced centers is parallel to cervical thyroidectomy.
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spelling doaj.art-634b522f10fd4d1a9bcb702afef15bf32023-02-15T16:21:45ZengKARE PublishingErciyes Medical Journal2149-22472019-09-0141326126410.14744/etd.2019.37542EMJ-37542Surgery of Retrosternal Thyroid: Evaluation of 36 CasesAlperen Vural0Emrah Gülmez1Ömer Faruk Demir2Kerem Kökoğlu3Imdat Yüce4Sedat Çağlı5Department of Otorhinolaryngology, Erciyes University Faculty of Medicine, Kayseri, TurkeyDepartment of Otorhinolaryngology, Erciyes University Faculty of Medicine, Kayseri, TurkeyDepartment of Thoracic Surgery, Erciyes University Faculty of Medicine, Kayseri, TurkeyDepartment of Otorhinolaryngology, Kayseri Training and Research Hospital, Kayseri, TurkeyDepartment of Otorhinolaryngology, Erciyes University Faculty of Medicine, Kayseri, TurkeyDepartment of Otorhinolaryngology, Erciyes University Faculty of Medicine, Kayseri, TurkeyObjective: Retrosternal thyroid is the presence of thyroid tissue in the mediastinum either by enlarging of the cervical or by an ectopic mediastinal thyroid. Surgery for a retrosternal thyroid has technical differences than conventional cervical thyroid surgery and has a higher risk of complications. This paper aims to analyze the cases with retrosternal thyroid and to evaluate the outcomes of the surgery. Materials and Methods: Retrospective analysis in terms of age, sex, clinical course, thyroid hormone levels, parathormone (PTH) levels, diagnostic methods, and fine needle aspiration cytology (FNAC) results and complications of 36 cases that underwent surgery was performed. Results: In addition to routine evaluation for thyroid pathology, computerized tomography was used for each patient. Thirty-four surgeries were completed with a cervical incision, one with a sternotomy and one with a thoracotomy. Four patients (11.1%) experienced temporary postoperative hypocalcemia, and one patient had a transient vocal cord immobility. Neither permanent hypocalcemia nor vocal cord paralysis was present in any of the patients postoperatively. Conclusion: Planning surgery as early as possible is suggested to avoid compression symptoms and possible malignancy. Cervical approach is mostly enough for the majority of patients; however, in case of a need of an additional (transthoracic) approach, multidisciplinary planning with thoracic surgeons is proposed. The risk of complications in experienced centers is parallel to cervical thyroidectomy.https://jag.journalagent.com/z4/download_fulltext.asp?pdir=erciyesmedj&un=EMJ-37542mediastinal neoplasmsthyroidsurgery.
spellingShingle Alperen Vural
Emrah Gülmez
Ömer Faruk Demir
Kerem Kökoğlu
Imdat Yüce
Sedat Çağlı
Surgery of Retrosternal Thyroid: Evaluation of 36 Cases
Erciyes Medical Journal
mediastinal neoplasms
thyroid
surgery.
title Surgery of Retrosternal Thyroid: Evaluation of 36 Cases
title_full Surgery of Retrosternal Thyroid: Evaluation of 36 Cases
title_fullStr Surgery of Retrosternal Thyroid: Evaluation of 36 Cases
title_full_unstemmed Surgery of Retrosternal Thyroid: Evaluation of 36 Cases
title_short Surgery of Retrosternal Thyroid: Evaluation of 36 Cases
title_sort surgery of retrosternal thyroid evaluation of 36 cases
topic mediastinal neoplasms
thyroid
surgery.
url https://jag.journalagent.com/z4/download_fulltext.asp?pdir=erciyesmedj&un=EMJ-37542
work_keys_str_mv AT alperenvural surgeryofretrosternalthyroidevaluationof36cases
AT emrahgulmez surgeryofretrosternalthyroidevaluationof36cases
AT omerfarukdemir surgeryofretrosternalthyroidevaluationof36cases
AT keremkokoglu surgeryofretrosternalthyroidevaluationof36cases
AT imdatyuce surgeryofretrosternalthyroidevaluationof36cases
AT sedatcaglı surgeryofretrosternalthyroidevaluationof36cases