ABSTRACT
Thymectomy is an established therapy in the management of generalized myasthenia gravis (MG) and can be implemented as a supplement to medical therapy, or in cases where medical therapy has failed to improve symptoms. The course of the disease is highly variable and the severity of the disease often changes. The timing of thymectomy is controversial, but most agree that pediatric patients who present with the disease do better with thymectomy. Nearly 50% of patients with thymic tumors present with symptoms of MG. The majority of others are asymptomatic but may present with chest pain, dyspnea, cough, fatigue, and weight loss. Most patients with MG are on anticholinesterase therapy and may be on steroids as well. A sternotomy is a relatively standard and straightforward approach. Transverse cervical incision has been advocated to avoid the morbidity of a sternotomy, especially the respiratory compromise.
