Abstract
Myasthenia Gravis is a disorder of neuromuscular transmission in which the Thymus play a central role in its pathogenesis. We have reviewed 62 patients with myasthenia gravis in whom maximal thymectomy was performed. There were 41 female and 21 male with an average age of 28.2 years (range 9-46 years). The mean duration of the disease was 33.3 months (range 1-240 months). According to Osserman classifications there were 6, 24,23 and 8 patients in the classes I,II,III and IV respectively. Maximal thymectomy included a transcervical and transsternal approach to remove the thymus and the surrounding tissue to include possible sites of ectopic thymic tissue. There were no operative mortality and 10 patients developed complications (16.4%). Thymic hyperplasia was found in 43 cases, atrophy in 13 and thymoma in 5. During an average follow up period of 5.4 years (range 1-10 years) complete remission was noted in 43.9%, improvement in 47.3%. The remaining 8.8% did not improve after surgery. Univariate analysis revealed that sex, age, thymic histology, and the presence of ectopic thymic tissue had an adverse effect on the complete remission rate.