MANAGEMENT OF PATIENTS WITH SUBSTERNAL GOITERS

Substernal goiters, particularly when asymptomatic, frequently are neglected. This article discusses the incidence, pathogenesis, types, histology (and rate of malignancy), symptomatology, physical findings, diagnostic procedures, and medical and surgical management of substernal goiters, as well as the outcome of substernal goiter therapy. Life-threatening respiratory distress should be avoided with prophylactic or therapeutic early surgical intervention, for, in experienced hands, morbidity rate is low, complications unusual, and overall prognosis excellent.