<prompt> Thoracic extension of cervical goitre is usually approached through:NeckChestCombined cervico-thoracic routeThoracoscopic  <response>: Virtually all Intrathoracic goiters can be removed via a cervical incision. - Schwartz SxA thoracic approach median sternotomy may be needed in the following casespatients 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 orto 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 bePrimaryconstitute only 1 of all mediastinal goitersarise 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. 