Diagnostic and Surgical Considerations on Mediastinal (Intrathoracic) Goiter

1. Forty-six patients with mediastinal (intrathoracic) goiter, operated upon during a period of 15 years (1947-1962), were reviewed. During the same time the total number of operations for goiter was 1486. 2. Mediastinal goiter is predominant in women of advanced age. 3. The condition is best diagnosed by chest x-ray examination, including frontal and lateral views. The importance of an x-ray examination with the beams horizontal at the very level of the jugular notch is stressed. Scintigram is a valuable diagnostic adjunct. 4. All mediastinal goiters should be removed, for the fact that they are mediastinal is proof that they show a tendency to grow. 5. The operative field should be approached via a Kocher incision and, if necessary, by supplementary splitting of the sternum. Lateral thoracotomy should not be used except in cases with true aberrant goiter, and for those cases in which the diagnosis of goiter is not really firm. 6. All patients were operated upon under general anesthesia with endotracheal intubation.