Surgical management of retrosternal thyroid disease: a decennial retrospective analysis

A universally recognized definition of retrosternal thyroid pathology remains elusive. In high-volume centers the cervical approach is sufficient and the rates of thoracic surgical approach is less than 1%. Computed tomography (CT) or magnetic resonance imaging (MRI) of the cervical region are the modalities of choice for investigating the retrosternal component of the thyroid, as they allow accurate assessment of mediastinal extension and facilitate surgical planning. In our study, the integration of the Huins classification and the Cohen & Cho classification proved to be a valid predictive factor for identifying cases that may require a surgical approach beyond the classical Kocher-type cervicotomy. We recommend that retrosternal thyroid pathologies be managed in referral centers equipped with multidisciplinary expertise and adequate surgical experience to ensure optimal outcomes.