The transcervical approach to the superior mediastinum.

We describe our experience with the transcervical approach for the surgical treatment of nonthyroidal superior mediastinal masses. With careful patient selection, proper preoperative workup, and proper operative positioning and technique, the entire superior mediastinum may be explored, thus avoiding the significant morbidity associated with the transsternal route. The transcervical approach requires a thorough knowledge of the surgical anatomy. Nine patients underwent transcervical exploration of the superior mediastinum. The indications included parathyroid adenoma, thymoma, congenital cyst, hemangioma, adenocarcinoma, and thymectomy for myasthenia gravis. We specifically discuss the role of thymectomy in the treatment of myasthenia gravis.