Abstract
This study reviewed the surgical approaches and safety outcomes in six cases of sternotomy performed at the Department of Otolaryngology and Head and Neck Surgery, University of Tokyo Hospital, over a three-year period from January 2021 to December 2023. The histopathological diagnoses included papillary thyroid carcinoma in five cases and squamous cell carcinoma in one case. Four lesions were in contact with the superior surface of the brachiocephalic vein, one was positioned dorsal to the brachiocephalic vein, and one case exhibited invasion into the venous angle. An L-shaped sternal incision was made at the first intercostal space after dissecting the sternothyroid muscle from the posterior surface of the sternum. A transmanubrial approach （TMA） was added in one case involving lesions extending around the venous angle. No postoperative complications, including sternotomy-related infections or functional impairments, were observed. This study suggests that a comprehensive understanding of sternal anatomy enables sternotomy to be performed safely by head and neck surgeons.
