Thoracic extension of cervical goitre is usually approached through:

"Virtually all Intrathoracic goiters can be removed via a cervical incision." - Schwartz Sx A thoracic approach (median sternotomy) may be needed in the following cases patients with primary mediastinal goiters with no thyroid tissue in the neck. patient with previous thyroid operations who may have developed parasitic, mediastinal vessels. patients with invasive thyroid cancers for their complete removal or to control mediastinal bleeding during the operation. Also know. A goiter is said to be mediastinal if at least 50% of thyroid tissue is located intrathoracically. Mediastinal goiters can be Primary constitute only 1% of all mediastinal goiters arise from ectopic thyroid tissue. do not have any connection with the thyroid tissue in the neck. derives its blood supply from the mediastinum. Secondary Mediastinal arise from downward extension of cervical thyroid tissue. derive their blood supply from the thyroid vessels of neck.