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Is manubrium limited mini-sternotomy an alternative for traditional full sternotomy in cases with massive mediastinal (retrosternal) goiter? A case report

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ABSTRACT

Although most mediastinal goiters (MG) are operable by a cervical approach, some cases require sternotomy. Manubrium limited mini-sternotomy (MLMS) is an alternative method for traditional full sternotomy in subjects with MG. We present the case of a 45 year-old male subject who was operated for a total MG. The nodular mass was conical in shape and extended beyond the aortic arch and tracheal bifurcation. Sternotomy was decided, because excision via cervical Kocher incision was not safe. The nodular mass was extracted from the mediastinum easily via MLMS. The postoperative period was uneventful, without any complication, and the patient was discharged from the hospital after two days. He returned to his normal life within one month. This case shows that MLMS is a convenient and easy alternative for traditional full sternotomy in subjects with MG.
Key words: mediastinal goiter, manubrium limited mini-sternotomy, sternotomy.

INTRODUCTION
A vast majority of mediastinal goiters (MG) are successfully operated through a cervical approach1. Sternotomy is an alternative and valuable method in patients in whom the gland cannot be safely removed via a cervical incision. This paper discusses the manubrium limited ministernotomy (partial upper sternotomy or manubriotomy) (MLMS) as an alternative for standard sternotomy in subjects with MG that could not be extracted by a cervical approach.

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