Swellings of the Suprasternal Space of Burns

The suprasternal space (SSS) of Burns is a space of the inferior part of the front of the neck that lies inferior to the hyoid bone. The superficial layer of the deep cervical fascia divides into anterior and posterior leaves to attach to the respective borders of the suprasternal (jugular) notch, forming this small space, approximately 2 cm superior to the manubrium. Anatomically, the SSS of Burns is anterior to the sternohyoid muscle, posterior to the sternocleidomastoid muscle, medial to the lateral border of the sternohyoid muscle, and superior to the clavicle and sternum. A patient may present with a mass (swelling) in the SSS of Burns at the lower part of the midline of the neck. This chapter discusses the possible differentials, which include enlarged lymph nodes, lipoma, teratoma, thymoma, aneurysm of the aorta or innominate artery, and high (cervical) aortic arch. Greater attention should specifically be paid to the SSS as an area with the potential for lymph node metastasis from papillary thyroid carcinoma.