Head and Neck
Version of Record online: 3 DEC 2010
Copyright © 2010 The American Laryngological, Rhinological, and Otological Society, Inc.
Volume 121, Issue 1, pages 60–67, January 2011
How to Cite
Shin, J. J., Grillo, H. C., Mathisen, D., Katlic, M. R., Zurakowski, D., Kamani, D. and Randolph, G. W. (2011), The surgical management of goiter: Part I. preoperative evaluation. The Laryngoscope, 121: 60–67. doi: 10.1002/lary.21084
This research did not receive any financial support.
The authors have no conflicts of interests to disclose.
- Issue online: 22 DEC 2010
- Version of Record online: 3 DEC 2010
- Manuscript Accepted: 24 MAY 2010
- Manuscript Received: 23 DEC 2009
- substernal goiter;
- thyroid surgery;
- thyroid disease management;
- thyroid neoplasm;
- recurrent laryngeal nerve injury;
- Level of Evidence: 3b.
Our overarching objective is to provide a comprehensive analysis of goiter data in two paired articles. This first article focuses on the preoperative evaluation. The following null hypotheses have been tested: 1) there is no correlation between goiter size and preoperative symptoms, 2) there is no correlation between preoperative neck imaging abnormalities and preoperative symptoms, and 3) there are no predictors for goiter recurrence.
A retrospective review of 200 consecutive thyroidectomies meeting inclusion/exclusion criteria for cervical or substernal goiter.
The mean specimen size was 10.5 ± 4.8 cm and 142.9 ± 113.3 grams. There was a positive correlation between goiter size and preoperative shortness of breath (P = .02). The presence of substernal goiter was significantly correlated with tracheal deviation and tracheal compression (P < .01) on neck imaging. There was strong correlation between preoperative shortness of breath and tracheal compression (P < .001) on neck computed tomography (CT), but not tracheal deviation. The need for revision surgery was significantly associated with female gender (odds ratio 3.0; 95% confidence interval [CI] 1.5, 6.1, and a positive family history of thyroid disease (odds ratio 6.5 [2.4, 17.3]).
Goiter size is associated with increasing symptoms. Tracheal compression but not deviation was related to shortness of breath. Females and patients with a positive family history of goiter have an increased risk of goiter recurrence. Laryngoscope, 2011