Obviating the need for sternotomy: Safety and effectiveness of microdebrider use for retrosternal goiter

Obviating the need for sternotomy: Safety and effectiveness of microdebrider use for retrosternal... INTRODUCTIONRetrosternal goiters are documented in 2%‐26% of all thyroidectomies, depending on the defining criteria, especially because the term is vague with no uniform definition. The most commonly accepted definitions describe a retrosternal goiter as an enlarged thyroid that has descended below the plane of the thoracic inlet, or has >50% of its mass lying inferior to the thoracic inlet. The clinical presentation of a retrosternal goiter varies among patients, ranging from asymptomatic or slight discomfort to a major dysfunction affecting airway and swallowing, and even compression of large vessels. The surgical management of a retrosternal goiter varies, ranging from subtotal or complete hemithyroidectomy to total removal of the gland. Regardless of the surgical approach, such surgery is challenging and involves a higher risk for the patient, with an increased morbidity, especially if a sternotomy is performed.In this article, we describe our surgical technique of intracapsular volume reduction in 26 patients over 10 years using a microdebrider (which is usually used in endoscopic sinus surgery), as part of a hemithyroidectomy or total thyroidectomy, which has completely avoided the need for sternotomy in our patients with retrosternal goiters without increasing the risk to the patient.MATERIALS AND METHODSThis retrospective study was of http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Head & Neck: Journal for the Sciences & Specialties of the Head and Neck Wiley

Obviating the need for sternotomy: Safety and effectiveness of microdebrider use for retrosternal goiter

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Publisher
Wiley Subscription Services, Inc., A Wiley Company
Copyright
© 2018 Wiley Periodicals, Inc.
ISSN
1043-3074
eISSN
1097-0347
D.O.I.
10.1002/hed.25070
Publisher site
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Abstract

INTRODUCTIONRetrosternal goiters are documented in 2%‐26% of all thyroidectomies, depending on the defining criteria, especially because the term is vague with no uniform definition. The most commonly accepted definitions describe a retrosternal goiter as an enlarged thyroid that has descended below the plane of the thoracic inlet, or has >50% of its mass lying inferior to the thoracic inlet. The clinical presentation of a retrosternal goiter varies among patients, ranging from asymptomatic or slight discomfort to a major dysfunction affecting airway and swallowing, and even compression of large vessels. The surgical management of a retrosternal goiter varies, ranging from subtotal or complete hemithyroidectomy to total removal of the gland. Regardless of the surgical approach, such surgery is challenging and involves a higher risk for the patient, with an increased morbidity, especially if a sternotomy is performed.In this article, we describe our surgical technique of intracapsular volume reduction in 26 patients over 10 years using a microdebrider (which is usually used in endoscopic sinus surgery), as part of a hemithyroidectomy or total thyroidectomy, which has completely avoided the need for sternotomy in our patients with retrosternal goiters without increasing the risk to the patient.MATERIALS AND METHODSThis retrospective study was of

Journal

Head & Neck: Journal for the Sciences & Specialties of the Head and NeckWiley

Published: Jan 1, 2018

Keywords: ; ; ; ;

References

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