Thyroidectomy technique for the large thyroid mass with substernal extension

Abstract

Removal of large thyroid tumors with substernal or intrathoracic extension requires a surgical technique that varies from standard thyroidectomy. We have developed such a technique that uses a cervical incision and combines clear access to the mass with low morbidity. The principal features include complete sternocleidomastoid mobilization and early identification of the neurovascular pedicle through a lateral approach. In this article, we describe the elements of our technique in detail, from preoperative considerations through wound closure, and discuss the debate concerning the ideal treatment of these challenging tumors.