Boeckx W, Gruwez J, Van Genechten F
Acta Chir Belg. 1978 Nov-Dec;77(6):401-7.
One is often obliged to resect intrathoracic goiters. This is not directed towards functional problems but towards the local compression on other organs in the vicinity. Goiters that extend through the cervicomediastinal inlet are of this kind. In cases where the major part is in the mediastinum there still exists a continuity with the cervical part. Most cases can be resected by a cervicostomy. The vascularization comes from the neck except in true thoraic goiters. This makes it possible to ligate the vessels before extracting the gland. In difficult cases a mid sternotomy may be useful so that all thoracic goiters can be operated safely.