2009 Volume 19 Issue 3 Pages 191-197
Although most cases of thyroidectomy are completed with only a collar incision, sometimes a sternotomy is required for good visualization of the mediastinal extension of the thyroid tumors or lymph node metastases.
We describe here six cases of thyroid tumor that was resected by sternotomy. We analyzed the pre-operative diagnosis, indications of sternotomy, type of sternotomy, airway conservation and complications. Five of six cases were carcinoma, four of which were papillary carcinoma and one of which was poorly differentiated carcinoma. One of the six cases was a benign adenomatous goitor extending into the posterior mediastinum.
All of carcinoma cases showed possible extra-capsular extension adhered to the trachea or esophagus by computed tomography examination. The case of benign adenomatous goiter showed remarkable extension to the posterior mediastinum.
We performed an L-shaped or reversed L-shaped sternotomoy except for one case of median sternotomy. A tracheostomy was performed on the former three cases for airway conservation after surgery, but tracheal intubation was performed on the recent two cases. Mediastinitis, regarded as a very severe complication after sternotomy, did not occur in any cases.
