Does the diameter of the thoracic inlet influence the formation of retrosternal goiter?

Objective: Find an association between diameter of the Thoracic Inlet (TI) and RSG to determine whether the TI would function as a natural anatomical barrier to prevent the passage of the goiters to the thoracic cavity. Methods: A retrospective study was conducted with patients submitted to total th...

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Main Authors: Leonardo Daniel Manzano Pasquel, Daniel Abreu Rocha, Yasmin Laryssa Moura Guimaraes, Gustavo Fernandes de Alvarenga, Mauricio Kase, Júlia Scomparin Magalhãnes, Regina Lúcia Elia Gomes, Ledo Mazzei Massoni Neto, Renata Lorencetti Mahmoud, Leandro Luongo de Matos, Vergilius José Furtado de Araujo Filho, Claudio Roberto Cernea
Format: Article
Language:English
Published: Elsevier 2025-07-01
Series:Brazilian Journal of Otorhinolaryngology
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Online Access:http://www.sciencedirect.com/science/article/pii/S1808869425000400
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author Leonardo Daniel Manzano Pasquel
Daniel Abreu Rocha
Yasmin Laryssa Moura Guimaraes
Gustavo Fernandes de Alvarenga
Mauricio Kase
Júlia Scomparin Magalhãnes
Regina Lúcia Elia Gomes
Ledo Mazzei Massoni Neto
Renata Lorencetti Mahmoud
Leandro Luongo de Matos
Vergilius José Furtado de Araujo Filho
Claudio Roberto Cernea
author_facet Leonardo Daniel Manzano Pasquel
Daniel Abreu Rocha
Yasmin Laryssa Moura Guimaraes
Gustavo Fernandes de Alvarenga
Mauricio Kase
Júlia Scomparin Magalhãnes
Regina Lúcia Elia Gomes
Ledo Mazzei Massoni Neto
Renata Lorencetti Mahmoud
Leandro Luongo de Matos
Vergilius José Furtado de Araujo Filho
Claudio Roberto Cernea
author_sort Leonardo Daniel Manzano Pasquel
collection DOAJ
description Objective: Find an association between diameter of the Thoracic Inlet (TI) and RSG to determine whether the TI would function as a natural anatomical barrier to prevent the passage of the goiters to the thoracic cavity. Methods: A retrospective study was conducted with patients submitted to total thyroidectomy, with goiter greater than 50 cm3, who underwent Computed Tomography (CT) preoperatively to measure the TI volume. The values obtained from each continuous variable of parametric distribution were organized and described as mean and standard deviation. The distributions were defined as non-parametric by the Kolmogorov-Smirnov test. The Mann-Whitney test was used to compare two sample populations. Results: A total of 173 patients submitted to total thyroidectomy were evaluated, and 54 patients met the inclusion criteria of the study. 85.2% were female, with a mean age of 57-years. The mean diameter of the TI was 5679 mm2. 42% of the patients presented some degree of RSG. The distance below the TI ranged from 0.2 to 5 cm. Conclusion: No significant association was found between diameter of the thoracic inlet and retrosternal goiter, demonstrating that RSG can be present regardless of the TI diameter. Statistically significant association was observed between patients with larger thyroid volume and the likelihood of this tissue to extend to the thoracic cavity. Level of evidence: Level IV.
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spelling doaj-art-40a4b75b0a7d4e6db664135ba5b493cc2025-08-20T03:26:27ZengElsevierBrazilian Journal of Otorhinolaryngology1808-86942025-07-019110159710.1016/j.bjorl.2025.101597Does the diameter of the thoracic inlet influence the formation of retrosternal goiter?Leonardo Daniel Manzano Pasquel0Daniel Abreu Rocha1Yasmin Laryssa Moura Guimaraes2Gustavo Fernandes de Alvarenga3Mauricio Kase4Júlia Scomparin Magalhãnes5Regina Lúcia Elia Gomes6Ledo Mazzei Massoni Neto7Renata Lorencetti Mahmoud8Leandro Luongo de Matos9Vergilius José Furtado de Araujo Filho10Claudio Roberto Cernea11Universidade de São Paulo (USP), Faculdade de Medicina (FM), Departamento da Cirurgia de Cabeça e Pescoço, São Paulo, SP, BrazilUniversidade de São Paulo (USP), Faculdade de Medicina (FM), Departamento da Cirurgia de Cabeça e Pescoço, São Paulo, SP, BrazilUniversidade de São Paulo (USP), Faculdade de Medicina (FM), Departamento da Cirurgia de Cabeça e Pescoço, São Paulo, SP, BrazilUniversidade de São Paulo (USP), Faculdade de Medicina (FM), Departamento da Cirurgia de Cabeça e Pescoço, São Paulo, SP, BrazilUniversidade de São Paulo (USP), Faculdade de Medicina (FM), Departamento de Radiologia, São Paulo, SP, BrazilUniversidade de São Paulo (USP), Faculdade de Medicina (FM), Departamento de Radiologia, São Paulo, SP, BrazilUniversidade de São Paulo (USP), Faculdade de Medicina (FM), Departamento de Radiologia, São Paulo, SP, BrazilUniversidade de São Paulo (USP), Faculdade de Medicina (FM), Departamento da Cirurgia de Cabeça e Pescoço, São Paulo, SP, BrazilUniversidade de São Paulo (USP), Faculdade de Medicina (FM), Departamento da Cirurgia de Cabeça e Pescoço, São Paulo, SP, BrazilUniversidade de São Paulo (USP), Faculdade de Medicina (FM), Departamento da Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil; Corresponding author.Universidade de São Paulo (USP), Faculdade de Medicina (FM), Departamento da Cirurgia de Cabeça e Pescoço, São Paulo, SP, BrazilUniversidade de São Paulo (USP), Faculdade de Medicina (FM), Departamento da Cirurgia de Cabeça e Pescoço, São Paulo, SP, BrazilObjective: Find an association between diameter of the Thoracic Inlet (TI) and RSG to determine whether the TI would function as a natural anatomical barrier to prevent the passage of the goiters to the thoracic cavity. Methods: A retrospective study was conducted with patients submitted to total thyroidectomy, with goiter greater than 50 cm3, who underwent Computed Tomography (CT) preoperatively to measure the TI volume. The values obtained from each continuous variable of parametric distribution were organized and described as mean and standard deviation. The distributions were defined as non-parametric by the Kolmogorov-Smirnov test. The Mann-Whitney test was used to compare two sample populations. Results: A total of 173 patients submitted to total thyroidectomy were evaluated, and 54 patients met the inclusion criteria of the study. 85.2% were female, with a mean age of 57-years. The mean diameter of the TI was 5679 mm2. 42% of the patients presented some degree of RSG. The distance below the TI ranged from 0.2 to 5 cm. Conclusion: No significant association was found between diameter of the thoracic inlet and retrosternal goiter, demonstrating that RSG can be present regardless of the TI diameter. Statistically significant association was observed between patients with larger thyroid volume and the likelihood of this tissue to extend to the thoracic cavity. Level of evidence: Level IV.http://www.sciencedirect.com/science/article/pii/S1808869425000400GoiterRetrosternal goiterThoracic approachThoracic inlet
spellingShingle Leonardo Daniel Manzano Pasquel
Daniel Abreu Rocha
Yasmin Laryssa Moura Guimaraes
Gustavo Fernandes de Alvarenga
Mauricio Kase
Júlia Scomparin Magalhãnes
Regina Lúcia Elia Gomes
Ledo Mazzei Massoni Neto
Renata Lorencetti Mahmoud
Leandro Luongo de Matos
Vergilius José Furtado de Araujo Filho
Claudio Roberto Cernea
Does the diameter of the thoracic inlet influence the formation of retrosternal goiter?
Brazilian Journal of Otorhinolaryngology
Goiter
Retrosternal goiter
Thoracic approach
Thoracic inlet
title Does the diameter of the thoracic inlet influence the formation of retrosternal goiter?
title_full Does the diameter of the thoracic inlet influence the formation of retrosternal goiter?
title_fullStr Does the diameter of the thoracic inlet influence the formation of retrosternal goiter?
title_full_unstemmed Does the diameter of the thoracic inlet influence the formation of retrosternal goiter?
title_short Does the diameter of the thoracic inlet influence the formation of retrosternal goiter?
title_sort does the diameter of the thoracic inlet influence the formation of retrosternal goiter
topic Goiter
Retrosternal goiter
Thoracic approach
Thoracic inlet
url http://www.sciencedirect.com/science/article/pii/S1808869425000400
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