Surgery for substernal goiters can be technically demanding. Extensive mediastinal extension brings the thyroid gland into close quarters with vital intrathoracic structures. Proper preoperative planning is required to determine the potential need for an extracervical approach. Assessing the risk of requiring an extracervical approach is typically based on findings from cross-sectional imaging of the neck and chest. This article addresses the important anatomical considerations when resecting a large substernal goiter and also reviews various extracervical approaches.

中文翻译：

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胸骨下甲状腺肿的手术治疗。

胸骨下甲状腺肿的手术在技术上可能要求很高。广泛的纵隔伸展将甲状腺与重要的胸腔内结构紧密结合在一起。需要进行适当的术前计划，以确定可能需要采取宫颈外手术的方法。通常基于颈部和胸部横截面成像的发现来评估需要采取宫颈外入路的风险。本文讨论了切除大型胸骨后甲状腺肿时的重要解剖学注意事项，并概述了各种宫颈外治疗方法。