Surgical approach to the diagnosis of tumours occurring in the superior mediastinum.

The nature of tumours lying in the superior mediastinum can frequently be decided by the radiologist using a range of techniques varying in sophistication from the plain chest radiograph to transvenous biopsy. Histolocical proof of such lesions usually requires surgical exploration and of the methods available it is believed that mediastinotomy is the safest and most rewarding in terms of positive results. Radical excision of tumours and management of tracheal lesions require the greater surgical access afforded by thoracotomy, median sternotomy and the sternal resection of Grillo.