The surgical approach to retrosternal goiters: The role of computerized tomography

OBJECTIVE: To assess preoperative CT scans of pa-tients with a retrosternal goiter, with an objective of identifying features that are likely to predict the need for sternotomy at operation. STUDY DESIGN AND SETTING: A retrospective review of clinical notes and CT scans of patients who un-derwent thyroidectomy for retrosternal goiter at a large district general hospital in the United Kingdom between 1998 and 2002. RESULTS: Extension of the goiter to the level of the aortic arch, particularly when combined with tra-cheal involvement or major vessel displacement, increases the likelihood of requiring median ster-notomy. CONCLUSIONS: Most retrosternal goiters can be ap