The most common symptoms were the existence of a palpable cervical mass (56 percent), dysphagia in 12 cases (14 percent), dyspnea in 16 (19 percent), and 12 percent were asymptomatic. Most patients had long-standing goiter (mean duration: 11 years). The most successful study to diagnose the substernal goiter was computed tomography (100 percent), followed by chest radiography (85 percent). The mean dimention of tumor was 12 cm (5-15). There were 3 cases of reoperation for recurrence goiter after thyroidectomy in other hospitals. There were 82 patients who were operated on via a cervical approach, but especially there was 1 case underwent via a cervical approach by video-assisted. The mean operating time was 75 minutes ( 45-135). The mean blood lost was 150 ml (50-350). Early postoperative complications were hemorrhage, in 2 (2.4 percent), temporary hoarseness in 2 (2.4 percent), transient hypoca1cinema in 3 (3.6 percent). CT scan is the best exploration to evaluate intrathoracic extension of substernal goiters. VIDEO asisted thyroidectomy can be used to remove the substerial goiter without the need for sternotomy even in very large size of goiter.
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