Computed Tomography Findings Affecting the Decision of Sternotomy in Substernal Goiter

Objectives: Although thyroidectomy is completed with a cervical incision in most patients with substernal goiter (SG), sternotomies may be required occasionally. The purpose of this study is to examine computed tomography (CT) findings that may predict the need for sternotomy in SG surgery.
Methods: Neck-thoracic CT images of patients who underwent total thyroidectomy with the diagnosis of SG between 2013 and 2022 were retrospectively examined. The patients (n=41) were divided into two groups: sternotomies (n=6) and cervical (n=35). Preoperative pathological data, CT findings, and postoperative complications of the patients were recorded.
Results: The total thyroid volume of the sternotomy group (280.75±127.01 mm3) was significantly greater than that of the cervical group (155.38±74.18 mm3) (p=0.015). The retrosternal thyroid volume (mm3), thyroid craniocaudal, and anterior-posterior dimensions (mm) were significantly greater in the sternotomy group (p=0.001, p<0.001, and p=0.004, respectively). While the majority of mediastinal extension degrees in the cervical group were grade 1 (80%), grade 2 (83%) predominated in the sternotomy group (p=0.001).
Conclusion: The radiological findings of total thyroid volume, retrosternal thyroid tissue volume, retrosternal thyroid length, thyroid anterior-posterior dimension, and mediastinal extension degree on CT are valuable in predicting the decision to perform a sternotomy in SG surgery.

Substernal Guatrda Sternotomi Kararýný Etkileyen Bilgisayarlý Tomografi Bulgularý

Amaç: Substernal guatrlý (SG) hastalarda tiroidektomi genellikle servikal insizyonla tamamlanabilse de nadiren sternotomi ihtiyacý doðabilmektedir. Bu çalýþmanýn amacý SG cerrahisinde sternotomi kararýný öngörebilecek bilgisayarlý tomografi (BT) bulgularýný incelemektir.
Yöntemler: 2013-2022 yýllarý arasýnda SG tanýsýyla total tiroidektomi uygulanan hastalarýn boyun-göðüs BT görüntüleri geriye dönük olarak incelendi. Hastalar (n=41); Sternotomi (n=6) ve Servikal (n=35) grup olmak üzere ikiye ayrýldý. Hastalarýn preoperatif patolojik verileri, BT bulgularý ve postoperatif komplikasyonlarý kaydedildi.
Bulgular: Sternotomi grubunun total tiroid hacmi (280.75±127.01 mm3), Servikal gruptan (155.38±74.18 mm3) anlamlý ölçüde daha yüksekti (p=0.015). Retrosternal tiroid hacmi (mm3), kranio-kaudal ve anterior-posterior tiroid uzunluðu (mm) Sternotomi grubunda anlamlý olarak yüksekti (sýrasýyla; (p=0.00, p<0.001 ve p=0.004). Servikal grupta mediastinal uzaným derecesi çoðunlukla derece 1 (%80) iken, Sternotomi grubunda derece 2 (%83) hakimdi (p=0.001).
Sonuç: BT radyolojik bulgularýndan total tiroid hacmi, retrosternal tiroid hacmi, retrosternal tiroid uzunluðu, tiroid anterior-posterior boyutu ve mediastinal uzaným derecesi; substernal guatr cerrahisinde sternotomi uygulanmasý kararýný öngörmede deðerli bulgulardýr. (SETB-2023-03-036)