ACCESS TO THE SUPERIOR MEDIASTINUM

Surgical access for diseases that involve the superior mediastinum can be achieved without thoracotomy by utilizing the suprasternal approac h with extension of the head and neck and transection of the interclav icular Ligament, median sternotomy, resection of the medial third to o ne half of the clavicle, or resection of the manubrium sterni, There h as been minimal morbidity and no operative or postoperative mortality in a review of 53 consecutive patients, There has been no significant disability. Combined with exposure at the base of the neck, the access to the superior mediastinum is good to excellent.