Sternotomy in Thyroid Carcinoma: Experience of Loma Linda University Medical Center

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Hossam Thabet
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Sternotomy in Thyroid Carcinoma: Experience of Loma Linda University Medical Center Benjamin Bradford 1, Pedro A De Andrade Filho 1, Alfred Simental 1, Hannah Copeland 2, Allen Murga 2, Tracy Bailey

1 Sternotomy in Thyroid Carcinoma: Experience of Loma Linda University Medical Center Benjamin Bradford 1, Pedro A De Andrade Filho 1, Alfred Simental 1, Hannah Copeland 2, Allen Murga 2, Tracy Bailey 2, Khaled Bahjri 2, Charles Stewart IV 1, Jared Inman 1, Steve Lee 1, Jason Wallen 2 and Salman Zaheer 2 1 Loma Linda University Department of Otolaryngology-Head and Neck Surgery, 2 Loma Linda University Department of Cardiothoracic Surgery BACKGROUND Thyroid carcinoma that extends below the RESULTS CONCLUSIONS manubrium into the anterior mediastinum may require sternotomy for adequate surgical exposure There were 6 patients, 5 male and 1 There were no postoperative mortality, Risk of hypoparathyroidism is 66% in and removal. female, with mean age of 63 years, but temporary hypoparathyroidism was patients undergoing sternotomy and early (range: 47-76). Of those, 66.7% present in 4 of 6 patients, all of which calcium replacement should be considered, presented with a neck mass as the major resolved within 3 months. especially in centers without rapid PTH. complaint, with dysphagia being present One patient had postoperative unilateral Longer perioperative antibiotic coverage OBJECTIVE in 33.3%. vocal fold paralysis due to involvement should be considered in sternotomy patients The aim of this study was to determine the All patients had a chest CT or X-ray to of CN X, and 2 patients had chest as wound infection was observed in 33%. outcome and risk of median sternotomy in evaluate the mass extension, prior to the wound infection. thyroid carcinoma surgery and all cases included tumor Two patients needed tracheostomy for extension in the anterior mediastinum. airway management including one with All patients received partial median tracheal invasion requiring tracheal METHODS sternotomy. resection. A retrospective review of all patients who Pathologic exam revealed 5 papillary The mean hospital stay was 9 days required a median sternotomy for a and 1 follicular carcinoma. (range: 2-20 days), and mean follow-up thyroidectomy or completion thyroidectomy at was 362 days (range: 53 days to 3.6 between was performed in a single One patient presented with vocal fold years). For additional information please contact: institution with IRB approval. We reviewed 30 cases, of those only 6 had thyroid carcinoma. paralysis prior to surgery. Benjamin Bradford, MD Department of Otolaryngology-Head and Neck Surgery Loma Linda University Medical Center Bbradford@llu.edu

Treatment for sternoclavicular joint infections: a multi-institutional study

Original Article Treatment for sternoclavicular joint infections: a multi-institutional study Allen Murga, Hannah Copeland, Rachel Hargrove, Jason M. Wallen, Salman Zaheer Department of Thoracic and Cardiovascular