Pseudodysphagia due to omohyoid muscle syndrome

Lateral Neck Bulging and Pain on Swallowing in a Young Man

A 28-year-old man presents with a bulge on the left side of his neck and severe stabbing pain during swallowing. He had a history of a neck contusion 1 year prior with subcutaneous bleeding that had improved. What is your diagnosis?

Diagnostic value of high-frequency ultrasound in omohyoid muscle syndrome

PURPOSE

To investigate the diagnostic value of high-frequency ultrasound in omohyoid muscle syndrome.

MATERIAL AND METHODS

A retrospective analysis of 11 patients diagnosed with omohyoid muscle syndrome was carried out, and the characteristics of high-frequency ultrasound images were summarized.

RESULTS

Ultrasonography of the omohyoid muscle showed a narrow band of hypoechoic muscle bundle. The ultrasonographic manifestation of omohyoid muscle syndrome showed a thickening of the omohyoid muscle on the affected side. The omohyoid muscle on the affected side bulged forward during swallowing and lifted the overlying sternocleidomastoid muscle. The difference between the thickness of the omohyoid muscle intermediate tendon on the affected side and the healthy side at rest was statistically significant (t = 58.23, P < 0.001). The difference between the thickness of the affected omohyoid muscle intermediate tendon at rest and during swallowing was statistically significant (t = 14.57, P < 0.001). There was no statistically significant difference between the thickness of the omohyoid muscle intermediate tendon on the healthy side at rest and during swallowing (t = 0.56, P > 0.05).

CONCLUSION

High-frequency ultrasound is the preferred imaging method in the diagnosis of omohyoid muscle syndrome.

A Systematic Review of the Omohyoid Muscle Syndrome (OMS): Clinical Presentation, Diagnosis, and Treatment Options

OBJECTIVE

Omohyoid muscle syndrome (OMS) is a condition that causes a X-shaped lateral neck lump on swallowing, caused by the failure of the central tendon of the omohyoid muscle to restrict movement of the muscle during swallowing. We aim to review the etiology, pathophysiology, diagnostic tests, and management options for this condition.

DATA SOURCES

Pubmed, MEDLINE, EMBASE, and Cochrane databases were searched for all articles and abstracts related to OMS up to 29th July 2020.

REVIEW METHODS

A systematic review was performed, data extracted from relevant full text articles. Both quantitative data and qualitative data were analyzed.

RESULTS

Twenty cases of OMS were reported. Patients presented at a mean age of 36.0. All cases were Asian. There is a 7:3 ratio of males to females. The most common symptom was a transient neck mass. Most cases were managed conservatively with good prognosis. Open or endoscopic transection of the muscle and ultrasound-guided botulinum toxin injection were 3 treatment options, with no recurrence at 4 years, 6 months, and 6 months respectively.

CONCLUSION

OMS could be genetic as all cases were Asian in ethnicity. The deep cervical fascia which usually envelopes the omohyoid muscle may be weakened by stress as 20% of cases had a preceding traumatic event. Real-time ultrasonography establishes the diagnosis, demonstrating the anterolateral displacement of the sternocleidomastoid muscle by a thickened omohyoid muscle during swallowing. Surgical transection can achieve cure, but due to limited studies available, they should be reserved for patients who are extremely bothered. Intramuscular injection of botulinum toxin is an effective alternative, but recurrence is expected.

Duplicate Omohyoid Muscle Causing Progressive Dysphagia and Dyspnea: A Case Report

INTRODUCTION

Duplicate omohyoid muscles are uncommon anomalies and exceedingly rare causes of progressive clinical symptoms. The goals of this case report are to describe the clinical characteristics, cross-sectional imaging, intraoperative findings, and curative treatment of our patient, to develop a differential diagnosis for this condition, and to review the pertinent literature regarding this particular type of anomalous omohyoid muscle as one among many variations.

CASE PRESENTATION

A 20 year-old man presented with progressive limited neck range of motion followed by dysphagia and then dyspnea caused by his duplicate omohyoid muscle. He underwent curative surgery in 2015 at our tertiary care center.

DISCUSSION

Although rare, a duplicate omohyoid muscle should be considered in the differential diagnosis of dysphagia and dyspnea with concurrent central neck deformity. We report the first case, to our knowledge, of an anomalous omohyoid that caused significant progressive clinical symptoms. Direct excision of the restrictive anomalous tissue proved curative.

Theory and practice of laparoscopic surgery against omohyoid muscle syndrome

Omohyoid muscle syndrome (OMS) is a rare disease characterized as a protruding lateral neck mass feature during swallowing. Because there is a 5 cm scar after traditionally surgery, we designed a laparoscopic surgery procedure to meet the cosmetic needs of patients. From the year 2006 to 2016, there were 3 patients diagnosed as omohyoid muscle syndrome that underwent laparoscopic surgery. Operative and postoperative follow-up data were summarized. Average surgery time was 35 ± 13 min. Average blood loss was 3 ± 1 mL. No case converted to open surgery. No major vessel or nerve damage complications occurred. After the surgery, the neck mass completely disappeared during swallowing, and there were no operative scars on the neck. All patients were discharged within 2 days. During the follow-up of a year, no recurrence occurred. In conclusion, the endoscopic procedure is suitable for OMS. It's a safe, effective and cosmetic surgery.

Omohyoid Muscle Syndrome in a Mixed Martial Arts Athlete: A Case Report

Omohyoid muscle syndrome is a rare cause of an X-shaped bulging lateral neck mass that occurs on swallowing. This is a diagnostic case report of a 22-year-old mixed martial arts athlete who acquired this condition.

Endoscopic Surgery for Omohyoid Muscle Syndrome

BACKGROUND

Omohyoid muscle syndrome (OMS) (not omohyoid syndrome) is a rare clinical condition that has a characteristic feature of a protruding lateral neck mass during swallowing. The use of endoscopic surgery on the neck is now pretty well established for thyroid and parathyroid glands. Patients with OMS usually undergo simple surgical transection of the omohyoid muscle. The procedure leaves operative scars on the neck, and most patients worry about the cosmetic problems. We report here the first use of an endoscopic procedure instead of traditional surgery for treatment of OMS.

MATERIALS AND METHODS

We present a rare case of a 26-year-old Chinese man who noted a protruding mass involving the right side of his neck during the past 10 years. OMS was diagnosed. Laparoscopic simple transection of the omohyoid muscle by an ultrasonically activated scalpel was performed.

RESULTS

After laparoscopic transection of the omohyoid muscle, the neck mass completely disappeared during swallowing, and there were no operative scars on the neck.

CONCLUSIONS

To our knowledge, this is the first report of laparoscopy for treatment of OMS. We believe that the laparoscopic procedure is made acceptable for this unusual disease because of the cosmetic result.

Sternohyoid muscle syndrome

OBJECTIVES

Patients presenting with neck mass are challenging for many otolaryngologists. If a mass on the lower lateral neck exists with swallowing and disappears after swallowing, it has been diagnosed as an omohyoid syndrome in most literature. The mechanism of sternohyoid syndrome has not been proven or investigated before. We investigated sternohyoid syndrome, commonly misdiagnosed as an omohyoid syndrome.

METHODS AND PATIENTS

Two patients were investigated. Outpatient photography, computed tomography and operating findings were reviewed. We found that the sternohyoid muscle was inserted at an abnormal site, the midportion of the clavicle. There was no abnormality of other muscles. We also reviewed all literature that previously diagnosed this condition as an omohyoid syndrome.

RESULTS

There was no literature about sternohyoid syndrome. We found that the abnormal muscle is a sternohyoid muscle and not omohyoid muscle. The color of the left sternohyoid muscle was dark red, and the fascia covering the muscle was denuded. The muscle had lost elasticity and moved abnormally.

CONCLUSION

Our patients did not have omohyoid syndrome. The symptoms of omohyoid syndrome are the same as sternohyoid syndrome but the problematic muscle is different. This is the first known report diagnosing sternohyoid syndrome, and should be a consideration in the diagnosis of a lateral neck mass.

Ultrasound-guided injection of botulinum toxin in a patient with omohyoid muscle syndrome: a case report

Omohyoid muscle syndrome has a characteristic feature of a protruding lateral neck mass during swallowing. We present a case of omohyoid muscle syndrome diagnosed based on the clinical presentation and a dynamic imaging study. Botulinum toxin was injected into the inferior belly of one omohyoid muscle, and the neck mass resolved.

Internal jugular vein entrapment in a multiple sclerosis patient

We describe a multiple sclerosis patient presenting with compression of the internal jugular vein caused by aberrant omohyoid muscle. Previously this patient underwent balloon angioplasty of the same internal jugular vein. Ten months after this endovascular procedure, Doppler sonography revealed totally collapsed middle part of the treated vein with no outflow detected. Still, the vein widened and the flow was restored when the patient's mouth opened. Thus, the abnormality was likely to be caused by muscular compression. Surgical exploration confirmed that an atypical omohyoid muscle was squeezing the vein. Consequently, pathological muscle was transected. Sonographic control three weeks after surgical procedure revealed a decompressed vein with fully restored venous outflow. Although such a muscular compression can be successfully managed surgically, future research has to establish its clinical relevance.