Cervical leverage: A new procedure to deliver deep retrosternal goitres without thoracotomy.
INTRODUCTION
Although most retrosternal goitres can be removed through a standard collar incision, some cases require extra-cervical incisions for complete resection. We report a new technique to remove large retrosternal goitres without extra-cervical incisions.


PRESENTATION OF CASE
We present two cases in which a US Army-Navy (Parker-Langenback) retractor was used to deliver large retrosternal components into the cervical incisions.


DISCUSSION
This technique is useful in cases where the retrosternal component extends beyond the reach of the exploring finger and a well-developed plane can be developed between the gland and surrounding tissue.


CONCLUSION
The cervical leverage technique allows removal of a large retrosternal component through a cervical incision, thereby avoiding the attendant morbidity of a thoracotomy or median sternotomy. It should not be used if there is suspected neoplastic disease, dense adherence to or invasion of surrounding intra-thoracic structures.
['Naraynsingh|Vijay|V|', 'Ramarine|Ian|I|', 'Cawich|Shamir O|SO|', 'Maharaj|Ravi|R|', 'Dan|Dilip|D|']
Retrosternal Goitre Thoracotomy Mediastinal Thyroid