Total thymectomy by the transcervical approach

The transcervical method of removal of the thymus gland is the preferred method especially in myasthenia gravis. This technique substantially reduces the postoperative complications permitting a rapid painfree convalescence with a minimum of postoperative psychiatric problems and cosmetic disfigurement. Fifty-two patients with non-thymomatous myasthenia and 7 with high-lying thymoma have been operated on in the past 3 years by this method. In addition, in 1 case of hyperparathyroidism this technique proved invaluable immediately following a negative neck exploration. The morbidity and complication rate is so much reduced that the trans-sternal technique is now reserved for selected cases of thymoma only. One death has occurred in a near moribund patient with uncontrollable myasthenia and severe hyperthyroidism.