Superior mediastinal exposure.

Removal of disease from the superior mediastinum requires adequate visualization. This article reports another technique to gain access to this anatomic area. We describe here a selective series of nine patients who underwent resection of the medial one third of the clavicle in conjunction with primary surgery to remove disease from the superior mediastinum. The procedure is described in detail. Possible complications such as pneumothorax, transection of the subclavian artery or vein, hematoma, or abscess formation have not occurred. We recommend this procedure for patients with mediastinal lymph node disease as well as for patients with large substernal thyroid disease where exposure of the superior mediastinum is required.