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Ann Thorac Surg 1977;23:348-352
© 1977 The Society of Thoracic Surgeons

Articles

Contemporary Management of Myasthenia Gravis: The Clinical Role of Thymectomy

Scott L. Faulkner, M.D., Abdolreza Ehyai, M.D., R. Darryl Fisher, M.D., Gerald M. Fenichel, M.D., Harvey W. Bender, Jr., M.D.*

Department of Cardiac and Thoracic Surgery and the Department of Neurology, Vanderbilt University School of Medicine, Nashville, TN.

* Address reprint requests to Dr. Bender, Department of Cardiac and Thoracic Surgery, Vanderbilt University School of Medicine, Nashville, TN 37232.

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.




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