The Annals of Thoracic Surgery, Vol 23, 348-352, Copyright © 1977 by The Society of Thoracic Surgeons
Contemporary management of myasthenia gravis: the clinical role of thymectomy
SL Faulkner, A Ehyai, RD Fisher, GM Fenichel and HW Bender Jr
Thirty-six patients with myasthenia gravis have been evaluated and treated
over the past five years. Eleven patients had ocular myasthenia gravis and
responded well to anticholinesterase medications. Twenty- five patients had
generalized myasthenia gravis, and 22 of them were initially treated with
anticholinesterase medications; 18(82%) failed to improve or to maintain an
initial improvement on medication, and 14 of these 18 patients underwent
thymectomy. In addition, 3 patients underwent thymectomy as part of their
initial treatment during the later part of this study. All thymectomies
were performed through a median sternotomy. All 17 patients manifested
sustained improvement as judged by a gain in strength and decrease in
medications. Thymectomy is beneficial in the treatment of myasthenia
gravis, and it is most efficacious when performed early in the course of
the disease.