How do you treat Retrosternal goiter?
How do you treat Retrosternal goiter?
Surgical Therapy Surgical intervention is the treatment of choice for substernal goiter. In the case of benign disease, the extent of surgery is determined by the removal of the entire substernal component of a goiter as well as any other thyroid tissue responsible for obstructive symptomatology.
Why radioiodine therapy is not accepted in Retrosternal goitre?
In most cases, suppressive therapy with thyroxine is ineffective in reducing the size of multinodular goitres;1,2; radio-iodine therapy is both generally ineffective in large goitres2 and may induce acute inflammation and swelling of the gland with the potential for airway obstruction.
Can a goiter compress your trachea?
A goiter may cause compression of the trachea and the surrounding structures, and can occasionally lead to acute respiratory insufficiency [13-16]. Nevertheless, due to its slow development and patient adaptation, tracheal compression often remains unrecognized [13, 17, 18].
What is Retrosternal extension of thyroid?
A retrosternal thyroid refers to the abnormal location of all or part of the thyroid gland below the breastbone (sternum).
What is multi nodular goitre?
A multinodular goitre is a goitre where there are many lumps (nodules) that appear within the gland. This is probably the most common thyroid gland disorder. Nodules may be clearly visible or only discovered through examination or scans.
What size goiter should be removed?
Although the fine needle aspiration (FNA) biopsy is still the gold standard workup for thyroid nodules, its accuracy declines as the size of the goiter increases. Therefore, once the goiter or the nodule is larger than 4cm, surgery is generally recommended.
Can a goiter block your airway?
Objective. Benign nodular goiter (BNG) can cause narrowing of the upper airway. In some rare cases, obstruction of the upper airway also occurs.
What is the most useful tool for preoperative assessment of goiters?
Computed tomography scanning is currently the most useful tool in preoperative assessment of patient anatomy. In most cases, substernal goiters can be removed successfully through a transcervical approach, although transthoracic approaches are occasionally required.
What is the treatment of choice for substernal goiter?
Surgical intervention is the treatment of choice for substernal goiter.In the case of benign disease, the extent of surgery is determined by the removal of the entire substernal component of a goiter as well as any other thyroid tissue responsible for obstructive symptomatology.
How are goiter and hyperthyroidism treated?
Radioactive iodine therapy may be useful in the treatment of hyperthyroidism associated with goiters but usually is unhelpful in the management of obstructive symptoms.
How do you remove a goiter in the neck?
In most cases in which the goiter cannot be removed through a neck incision, a ministernotomy or partial upper sternotomy provides excellent exposure with little or no additional morbidity. Alternative approaches include partial resection of the clavicular head or thoracotomy.
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