CT cross-sectional imaging classification system for substernal goiter based on risk factors for an extracervical surgical approach

Giuseppe Mercante, Enrico Gabrielli, Corrado Pedroni, Debora Formisano, Laura Bertolini, Franco Nicoli, Roberto Valcavi, Verter Barbieri

Research output: Contribution to journalArticle

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 cranio-caudal 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.

Original languageEnglish
Pages (from-to)792-799
Number of pages8
JournalHead and Neck
Volume33
Issue number6
DOIs
Publication statusPublished - Jun 2011

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Keywords

  • classification
  • extracervical approach
  • sternotomy
  • substernal goiter
  • thyroid

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Mercante, G., Gabrielli, E., Pedroni, C., Formisano, D., Bertolini, L., Nicoli, F., Valcavi, R., & Barbieri, V. (2011). CT cross-sectional imaging classification system for substernal goiter based on risk factors for an extracervical surgical approach. Head and Neck, 33(6), 792-799. https://doi.org/10.1002/hed.21539