RETROSTERNAL GOITER - A 6-YEAR INSTITUTIONAL REVIEW

Retrosternal goiter is defined as any goiter in which at least 50 per Cent of the thyroid resides below the level of the thoracic inlet. The incidence of retrosternal goiter varies from 3 to 20 per cent with re spect to thyroidectomy patients. A retrospective chart review from Jun e 1991 to December 1997 found 232 thyroidectomies performed at our ins titution. Sixteen patients were found to have retrosternal goiters (6. 9%). The mean age was 57.8 years (range, 34-92). All were of benign pa thology. Symptoms included shortness of breath (68.8%), hoarseness (37 .5%), dysphagia (31.3%), and superior vena cava obstruction (6.25%). T hirteen patients were female (81.3%). Fifteen patients had surgical in tervention (93.8%). Total thyroidectomy was performed in nine cases (6 0%), whereas lobectomy was performed in six cases (40%). All treated p atients had complete resolution of symptoms. A cervical incision alone was used in 13 cases (86.7%). Complications consisted of one postoper ative pleural effusion and in one case a traumatic C5 nerve root compr ession occurred. There were no instances of long-term vocal cord paral ysis or hypoparathyroidism. There was no perioperative mortality. In t he majority of patients with retrosternal goiter, surgery can be done expeditiously through a cervical incision with minimal morbidity and m ortality.