Introduction
Retrosternal goiter (RG), also referred to as intrathoracic or
retrosternal, or cervico-mediastinal goiter, was first described by
Haller in 1794 but it still represents a challenge for inexperienced
head and neck and thoracic surgeons, as well as for anesthesiologists1,2. Clinically RGs are usually incidental findings,
yet they can present sometimes with life-threatening dyspnea. They pose
many issues in terms of airway management: because of tracheal
deviation, external compression, and risk of tracheomalacia and
cardiovascular collapse, RGs should be managed only in referral centers
where expected difficulties can be safely managed. In this regard, an
accurate preoperative work-up is mandatory in order to avoid
complications and to reduce the need for an extra-cervical approach. The
most recent review available on RG dates back to some years ago, and
since then the evolution of technology has brought in different
innovations, especially in new mini-invasive techniques such as
image-guided ablation or robotic-assisted transthoracic
surgery3.
The present review aims to critically discuss the published evidence in
the last five years on the medical and surgical management of RG, with
particular attention to the need for multidisciplinary management of
these patients.