Background. The purpose of this study was to identify risk factors for surgical extracervical approach in patients with substernal goiter. We used a novel classification system based on CT scan cross-sectional imaging (CSI) reconstruction. Methods. Medical records of 4297 patients with thyroid disease operated on at our department were reviewed. A CSI classification system defined substernal goiter in the craniocaudal dimension as: grade 1 (above aortic arch), grade 2 (level of aortic arch), and grade 3 (below aortic arch); in the anteroposterior dimension as type A (prevascular), type B (retrovascular-paratracheal), and type C (retrotracheal); in the latero-lateral dimension as: monolateral or bilateral. Results. The prevalence of substernal goiter was 222 of 4297 cases (5.1%). Fifteen of 222 cases (6.7%) required an extracervical approach due to grade >= 2 and/or type C substernal goiter (14 of 15 cases). Ten of 15 patients had malignancy. Conclusion. The CT-CSI classification system allows us to identify risk factors for extracervical surgical approach in substernal goiter. They are grade >= 2, type C substernal goiter, and malignancy. (C) 2010 Wiley Periodicals, Inc. Head Neck 33: 792-799, 2011
CT CROSS-SECTIONAL IMAGING CLASSIFICATION SYSTEM FOR SUBSTERNAL GOITER BASED ON RISK FACTORS FOR AN EXTRACERVICAL SURGICAL APPROACH
Mercante G;
2011-01-01
Abstract
Background. The purpose of this study was to identify risk factors for surgical extracervical approach in patients with substernal goiter. We used a novel classification system based on CT scan cross-sectional imaging (CSI) reconstruction. Methods. Medical records of 4297 patients with thyroid disease operated on at our department were reviewed. A CSI classification system defined substernal goiter in the craniocaudal dimension as: grade 1 (above aortic arch), grade 2 (level of aortic arch), and grade 3 (below aortic arch); in the anteroposterior dimension as type A (prevascular), type B (retrovascular-paratracheal), and type C (retrotracheal); in the latero-lateral dimension as: monolateral or bilateral. Results. The prevalence of substernal goiter was 222 of 4297 cases (5.1%). Fifteen of 222 cases (6.7%) required an extracervical approach due to grade >= 2 and/or type C substernal goiter (14 of 15 cases). Ten of 15 patients had malignancy. Conclusion. The CT-CSI classification system allows us to identify risk factors for extracervical surgical approach in substernal goiter. They are grade >= 2, type C substernal goiter, and malignancy. (C) 2010 Wiley Periodicals, Inc. Head Neck 33: 792-799, 2011I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
