Objective To explore the feasibility and safety of removal of benign substernal goiter through cervical approach and summarize the operation skill. Methods The clinical data of 85 cases diagnosed as benign substernal goiter from August 2002 to October 2011 in this hospital were analyzed retrospectively. Results The removal of benign substernal goiters in all 85 cases were performed through cervical approach without perioperative death，respiratory tract obstruction，massive haemorrhage，pneumothorax，hemothorax，chylus leakage，permanent impairment of recurrent laryngeal nerve，and permanent hypoparathyroidism. Three cases of hoarseness were found on 1-3d after operation，which returned to normal after symptomatic treatment. Four cases of numbness in the extremities and one case of mild convulsion happened，the symptoms were relieved through intravenous and oral administration of calcium treatment in 3-7d. The drainage volume was 35-220ml with （68±4.9） ml. The drainage tube was removed on postoperative 2-6d with an average 4.2d. Eighty-two patients were followed-up in 2 years after operation，no low calcium，low parathyroid hormone，hoarseness，and local goiter recurrence occurred. Two cases of hypothyroidism returned to normal after oral thyroxine dose adjustment. Conclusions Removal of the downward benign substernal goiter through cervical approach is safe and feasible. Sufficient exposure，stepwise procedure，blunt dissection in the precise gap，and combination of lifting with upbearing are the surgical skills for success.
ObjectiveTo understand the prevention and control effects of iodine deficiency disorders and its progression trend of disease condition in Chongqing. MethodsOne primary school was randomly selected as longitudinal surveillance sites in each of 4 counties in Chongqing city. A total of 90 children aged 8 to 10 years were randomly selected in each school with goiter, salt iodine, urinary iodine and intelligence detected. Meanwhile, in the four sites, urinary iodine of pregnant women and nursing women was tested. The goiter was examined by B-ultrasonograghy, urinary iodine by Ce arsenic acid digestion, and salt iodine by direct drop methods. ResultsA total of 360 children aged 8 to 10 years were investigated surveillance sites. The total goiter rate was 5.28%. There was no significant difference in the total goiter rate among different counties (P > 0.05). The median of iodized salt was 26.65 mg/kg. The coverage rate of iodized salt, consumption rate of qualified iodized salt and intake rate of qualified iodized salt was 99.72%, 91.09% and 97.04%, respectively. The medians of urine iodine of children, pregnant and nursing women were 238.15 μg/L, 218.15 μg/L and 252.90 μg/L, respectively. The cases with urine iodine lower than 100 μg/L accounted for 11.94%, 32.93% and 13.75%, respectively. The cases with urine iodine above 300 μg/L accounted for 34.17%, 13.41% and 43.75%, respectively. The mean intelligence quotient of children was 112.57. ConclusionThe goiter rate of schoolchildren in Chongqing city is relatively high and the population's iodine nutrition level is stable. However, the shortage and overdose of iodine still exist in Chongqing city.