ArticleBalkan medical journal2018
The Value of Preoperative Volumetric Analysis by Computerised Tomography of Retrosternal Goiter to Predict the Need for an Extra-Cervical Approach.
Article in Balkan medical journal, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Surgical approaches to the management of the intrathoracic goiter - A systematic review.Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale · 2025Pooled it
- Cervical Resection of a Suprapericardial Retrosternal Goiter Without Thoracotomy: A Case Report.Clinical case reports · 2026Article
- Surgical management of retrosternal thyroid disease: a decennial retrospective analysis.Frontiers in endocrinology · 2026Article
- Mediastinal Masses and Sternotomies: A Case Series.Cureus · 2025Article
- Diving retrosternal goiter and the dilemma of sternotomy: indications, predictors and surgical considerations.Kardiochirurgia i torakochirurgia polska = Polish journal of cardio-thoracic surgery · 2025Review
- Surgical management of anterior mediastinal tumors of thyroid origin: a comprehensive analysis of approaches, techniques, and outcomes.Journal of cardiothoracic surgery · 2024Article
- Unveiling the Accuracy of Ultrasonographic Assessment of Thyroid Volume: A Comparative Analysis of Ultrasonographic Measurements and Specimen Volumes.Journal of clinical medicine · 2023Article
- Retrosternal Thyroid with Mediastinal Extension: Surgical Approach and Management.Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India · 2023Article
- Surgical Management of 48 Patients with Retrosternal Goiter and Tracheal Stenosis: A Retrospective Clinical Study from a Single Surgical Center.Medical science monitor : international medical journal of experimental and clinical research · 2022Article
- Retrosternal Goitre: Anatomical Aspects and Technical Notes.Medicina (Kaunas, Lithuania) · 2022Review
- Substernal Goiter: From Definitions to Treatment.Sisli Etfal Hastanesi tip bulteni · 2022Review
- Split Sternotomy in Retrosternal Thyroid and Mediastinal Parathyroid Pathologies.Sisli Etfal Hastanesi tip bulteni · 2021Article
- Resection of mediastinal goiter extending to the carina with use of artificial pneumothorax, two-lung ventilation, and thoracoscopy, with the patient in a prone position.General thoracic and cardiovascular surgery · 2019Article
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Authors and funding
8 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundA thyroidectomy can be performed via a cervical incision in most patients with retrosternal goiter.
aimsTo investigate the correlation between the volume of the mediastinal portion of the thyroid gland and the need for an extra-cervical approach for retrosternal goiter. STUDY
designDiagnostic accuracy study.
methodsThe measurement of craniocaudal length and the volume of the mediastinal component of the thyroid gland on computerised tomography images was performed in 47 patients with retrosternal goiter. Of these 47 patients, 8 (17%) required an extra-cervical approach and were classified as group 1, and 39 (83%) patients that required a cervical incision were classified as group 2. Receiver operating characteristic analysis was performed to determine the cut-off value for the craniocaudal length and the volume of the mediastinal thyroid mass, which significantly correlated with an extra-cervical approach for retrosternal goiter.
resultsReoperative surgery was significantly more frequent in group 1 than in group 2 (50% vs 13%; p=0.03). The craniocaudal length of the mediastinal thyroid gland was significantly longer in group 1 than in group 2 (77±11 mm vs 31±21 mm, respectively; p=0.0001). The volume of the mediastinal component was significantly larger in group 1 compared to group 2 (264±106 cm3 vs 40±41 cm3, respectively; p=0.0001). The receiver operating characteristic curve of craniocaudal length and the volume of the mediastinal component identified ≥66 mm and ≥162 cm3 as the cut-off values with the maximum accuracy, respectively. The craniocaudal length of the thyroid mass below the thoracic inlet ≥66 mm or a volume of the mediastinal portion ≥162 cm3 were significantly associated with an extra-cervical approach (p=0.0001). For predicting an extra-cervical approach, the sensitivity, positive predictive value and negative predictive value of the cut-off value for craniocaudal length was 87.5%, 64% and 97%, respectively. For predicting an extra-cervical approach, the sensitivity, positive predictive value and negative predictive value of the cut-off values for the mediastinal volume were 100%, 89% and 100%, respectively.
conclusionA thyroid volume of ≥162 cm3 extending below the thoracic inlet was a significant determining factor for an extra-cervical approach, with a negative predictive value for the extra-cervical approach of 100% for retrosternal goiter with smaller volumes. Further studies with an increased number of patients are needed to determine the value of volumetric analysis of retrosternal goiter to predict the need for an extra-cervical approach in retrosternal goiter.
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