Assessment and management of cervico-mediastinal goiter. 2017

E Brenet, and X Dubernard, and J C Mérol, and M A Louges, and M Labrousse, and M Makeieff
Département d'otorhinolaryngologie et chirurgie cervico-faciale, CHU de Reims, 45, rue Cognacq-Jay, 51092 Reims cedex, France. Electronic address: estebanbrenet@gmail.com.

Cervico-mediastinal goiter is a particular entity from the point of view of thyroid surgery. Its volume, hardness and intrathoracic extension require the surgeon to adapt technique and perform a painstaking preoperative work-up, so as to draw up fully-fledged plan. CT is now indispensable, to anticipate risks and determine whether sternotomy is needed. Surgery seems to induce more postoperative complications than in conventional surgery, although they can be reduced by retrograde dissection of the inferior laryngeal nerve and downward dissection of the posterior side of the lobe to optimize control of adjacent structures. This surgery requires optimal teamwork between all of the specialties involved in patient management: medical, radiological, anesthesiological and surgical.

UI MeSH Term Description Entries
D008482 Mediastinum A membrane in the midline of the THORAX of mammals. It separates the lungs between the STERNUM in front and the VERTEBRAL COLUMN behind. It also surrounds the HEART, TRACHEA, ESOPHAGUS, THYMUS, and LYMPH NODES.
D006045 Goiter, Substernal An enlarged THYROID GLAND with at least 50% of the gland situated behind the STERNUM. It is an unusual presentation of an intrathoracic goiter. Substernal goiters frequently cause compression on the TRACHEA leading to deviation, narrowing, and respiratory symptoms. Goiter, Intrathoracic,Intrathoracic Goiter,Substernal Goiter,Goiters, Intrathoracic,Goiters, Substernal,Intrathoracic Goiters,Substernal Goiters
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012307 Risk Factors An aspect of personal behavior or lifestyle, environmental exposure, inborn or inherited characteristic, which, based on epidemiological evidence, is known to be associated with a health-related condition considered important to prevent. Health Correlates,Risk Factor Scores,Risk Scores,Social Risk Factors,Population at Risk,Populations at Risk,Correlates, Health,Factor, Risk,Factor, Social Risk,Factors, Social Risk,Risk Factor,Risk Factor Score,Risk Factor, Social,Risk Factors, Social,Risk Score,Score, Risk,Score, Risk Factor,Social Risk Factor
D013965 Thyroidectomy Surgical removal of the thyroid gland. (Dorland, 28th ed) Thyroidectomies
D013997 Time Factors Elements of limited time intervals, contributing to particular results or situations. Time Series,Factor, Time,Time Factor
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes
D056346 Sternotomy Making an incision in the STERNUM. Median Sternotomy,Median Sternotomies,Sternotomies,Sternotomies, Median,Sternotomy, Median
D061224 Laryngeal Nerve Injuries Traumatic injuries to the LARYNGEAL NERVE. Laryngeal Nerve Avulsion,Laryngeal Nerve Contusion,Laryngeal Nerve Transection,Laryngeal Nerve Trauma,Laryngeal Neuropathy, Traumatic,Avulsion, Laryngeal Nerve,Avulsions, Laryngeal Nerve,Contusion, Laryngeal Nerve,Contusions, Laryngeal Nerve,Injuries, Laryngeal Nerve,Injury, Laryngeal Nerve,Laryngeal Nerve Avulsions,Laryngeal Nerve Contusions,Laryngeal Nerve Injury,Laryngeal Nerve Transections,Laryngeal Nerve Traumas,Laryngeal Neuropathies, Traumatic,Nerve Avulsion, Laryngeal,Nerve Avulsions, Laryngeal,Nerve Contusion, Laryngeal,Nerve Contusions, Laryngeal,Nerve Injuries, Laryngeal,Nerve Injury, Laryngeal,Nerve Transection, Laryngeal,Nerve Transections, Laryngeal,Nerve Trauma, Laryngeal,Nerve Traumas, Laryngeal,Neuropathies, Traumatic Laryngeal,Neuropathy, Traumatic Laryngeal,Transection, Laryngeal Nerve,Transections, Laryngeal Nerve,Trauma, Laryngeal Nerve,Traumas, Laryngeal Nerve,Traumatic Laryngeal Neuropathies,Traumatic Laryngeal Neuropathy
D018570 Risk Assessment The qualitative or quantitative estimation of the likelihood of adverse effects that may result from exposure to specified health hazards or from the absence of beneficial influences. (Last, Dictionary of Epidemiology, 1988) Assessment, Risk,Benefit-Risk Assessment,Risk Analysis,Risk-Benefit Assessment,Health Risk Assessment,Risks and Benefits,Analysis, Risk,Assessment, Benefit-Risk,Assessment, Health Risk,Assessment, Risk-Benefit,Benefit Risk Assessment,Benefit-Risk Assessments,Benefits and Risks,Health Risk Assessments,Risk Analyses,Risk Assessment, Health,Risk Assessments,Risk Benefit Assessment,Risk-Benefit Assessments

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