Yano Teruhisa, Okada Takuro, Sato Hiroki, Tomioka Ryota, Tsukahara Kiyoaki
Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, Tokyo, Japan.
Case Rep Oncol. 2021 Sep 20;14(3):1353-1358. doi: 10.1159/000518532. eCollection 2021 Sep-Dec.
Sternotomy is indicated when a goiter cannot be resected via a cervical incision, such as in the case of a substernal goiter extending beyond the aortic arch. In this article, we report a case of a large substernal goiter that was successfully removed using the cervical approach only. This is a case of a 68-year-old woman, diagnosed with goiter 20 years ago, who complained of a neck mass enlargement with associated cough. Pathological examination revealed no malignancy. Computed tomography (CT) scan showed an 11-cm thyroid mass reaching the level of the aortic arch. Preoperatively, we evaluated the substernal extent of the goiter via CT in the extended neck position to decide whether sternotomy was necessary. With the patient's neck extended, the goiter withdraws cranially above the aortic arch. The mass was then removed via the cervical approach without sternotomy. Preoperative CT in the extended neck position was thus deemed helpful in deciding whether or not sternotomy was required.
当甲状腺肿无法通过颈部切口切除时，如胸骨后甲状腺肿延伸至主动脉弓上方的情况，就需要进行胸骨切开术。在本文中，我们报告了一例仅通过颈部入路成功切除巨大胸骨后甲状腺肿的病例。这是一名68岁女性，20年前被诊断为甲状腺肿，她主诉颈部肿块增大并伴有咳嗽。病理检查未发现恶性病变。计算机断层扫描（CT）显示一个11厘米的甲状腺肿块延伸至主动脉弓水平。术前，我们通过在颈部伸展位进行CT扫描来评估甲状腺肿的胸骨后范围，以决定是否需要进行胸骨切开术。当患者颈部伸展时，甲状腺肿向头侧回缩至主动脉弓上方。然后通过颈部入路切除肿块，未进行胸骨切开术。因此，术前在颈部伸展位进行CT扫描被认为有助于决定是否需要进行胸骨切开术。
