Syed Mosaddaque Iqbal, Imran Munir Memon.
Thyroidectomy in substernal goitre: our view point.
Pak J Surg Jan ;28(3):200-3.

Objective: To assess the need and complications of thyroidectomy in substernal goiter. Study Design: A descriptive retrospective study. Place & Duration : Department of Ear Nose Th roat and head & neck surgery,Fatima hospital Baqai Medical University and Department of Surgery Sir Syed Girls Medical College Karachi between January 2001 to September 2011. Patients and Methods: Seventeen patients of both gender and diff erent ages of substernal goiter who underwent thyroidectomy between January 2001 to September 2011 were studied regarding the indications and complications of thyroidectomy. Results: Only one patient( 5.88%) was presented with acute airway obstruction. Three (17.65%) patients were complained of dyspnoea in supine position,dysphagia and hoarseness were noticed in two (11.76%) patients while eleven (64.71%) of them were asymptomatic instead of obvious neck swelling.Total thyroidectomy was performed in fourteen (82.35%) cases and lobectomy with isthemectomy was the procedure adopted in three(17.65%) patients. CT scan was done in twelve (70.59%) of these cases.Majority of our cases i.e, sixteen (94.12%) were benign while malignancy was seen in one(5.88%) patient only.Complications like haematoma seen in one (5.88%) patient,recurrent laryngeal nerve injury was noted in two(11.76%) cases,hypoparathyroidism (transient) was seen in two(11.76%) of them and wound infection was observed in one(5.88%) patient.There was no mortality per and post-operatively and none of them had permanent hypoparathyroidism but one(5.88%) of our patient had permanent unilateral recurrent laryngeal narve injury. Conclusion: Sub-sternal goiter is oft en asymptomatic and thyroidectomy is the treatment of choice with very low mortality and morbidity

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