Predictors of Airway Complications After Thyroidectomy for Substernal
We used this new technique with all the modifications, including forced sternal elevation, thoracoscopic substernal
tunneling, pericostal suturing, and use of stabilizers to prevent bar displacement.
In other definitions of RSG, certain anatomic points, such as the fourth thoracic vertebra, the aortic arch, and the level of the carina are identified; notably, the thyroid gland must extend to these anatomical points or must be substernal
by at least 50%.
The patient reported that he experiences intermittent, substernal
, 8 out of 10, crushing left-sided chest pain radiating to his left mandible and left upper extremity.
A 21-year-old man with history of uncontrolled hypertension and asthma presented to the emergency department (ED) with sudden onset substernal
chest pain that started an hour before his arrival.
Several criteria have been described to establish the presence of ectopic thyroid tissue in the mediastinum versus a substernal
or a retrosternal extension of the thyroid gland.
Parameters NSCLC Parameters BCD n = 590 n =103 Gender Gender Male 402 Male 55 Female 188 Female 48 Age (year) Age (year) Range 28-86 Range 18-76 Mean 57.7 Mean 53.9 Pathological type Disease LAC 424 Hemangioma 4 LSCC 166 Hamartoma 6 T stage Inflammatory 8 pseudotumor T1 119 Fibrous nodules 6 T2 260 Tuberculosis 22 T3 176 Infection 33 T4 35 Lymphoproliferation 2 N stage Cysts 12 N0 172 Thymoma 3 N1 65 Substernal
thyroid 1 N2 222 Amyloidosis 1 N3 131 Lipoma 1 M stage Schwannoma 4 M0 376 -- -- M1 214 -- -- BCD: benign chest disease; NSCLC: non-small-cell lung cancer; LAC: lung adenocarcinoma; LSCC: lung squamous cell carcinoma.
On presentation, the patient complained of acute substernal
chest discomfort radiating to his back.
A 66-year-old man presents with substernal
chest pressure and dyspnea that has been present for 45 minutes.
Symptoms of rupture include substernal
chest pain, abdominal pain, and dyspnea.
Workup included a core biopsy confirming chondrosarcoma and Magnetic Resonance Imaging (MRI) defined an approximately 15cm primarily substernal
mass erupting through the xiphoid with mass effect and displacement of the heart and superior vena cava, extending into both pleural spaces.
The pain was described as 5/10 nonradiating, substernal
, with associated asthenia.