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Unno T, Ueha R, Tatebayashi M. Lateral Neck Bulging and Pain on Swallowing in a Young Man. JAMA Otolaryngol Head Neck Surg 2024; 150:519-520. [PMID: 38696216 DOI: 10.1001/jamaoto.2024.0797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2024]
Abstract
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?
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Affiliation(s)
- Takeshi Unno
- Department of Otolaryngology, The University of Tokyo, Tokyo, Japan
| | - Rumi Ueha
- Department of Otolaryngology, The University of Tokyo, Tokyo, Japan
- Swallowing Center, The University of Tokyo Hospital, Tokyo, Japan
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Cui L, Wang L, Wang T, Wang Y, Chen W, Qi H. Diagnostic value of high-frequency ultrasound in omohyoid muscle syndrome. J Med Ultrason (2001) 2024; 51:341-345. [PMID: 38296891 DOI: 10.1007/s10396-023-01407-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 11/14/2023] [Indexed: 02/02/2024]
Abstract
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.
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Affiliation(s)
- Liyuan Cui
- Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324, Jingwu Road, Jinan, 250021, Shandong, China
| | - Ling Wang
- Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324, Jingwu Road, Jinan, 250021, Shandong, China
| | - Tiezheng Wang
- Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324, Jingwu Road, Jinan, 250021, Shandong, China
| | - Yeting Wang
- Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324, Jingwu Road, Jinan, 250021, Shandong, China
| | - Wen Chen
- Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324, Jingwu Road, Jinan, 250021, Shandong, China
| | - Hengtao Qi
- Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324, Jingwu Road, Jinan, 250021, Shandong, China.
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Canoso JJ, Alvarez Nemegyei J, Naredo E, Murillo González J, Mérida Velasco JR, Hernández Díaz C, Olivas Vergara O, Alvarez Acosta JG, Navarro Zarza JE, Kalish RA. Palpation and Ultrasonography Reveal an Ignored Function of the Inferior Belly of Omohyoid: A Case Series and a Proof-of-Concept Study. Diagnostics (Basel) 2023; 13:3004. [PMID: 37761375 PMCID: PMC10529686 DOI: 10.3390/diagnostics13183004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 09/06/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Palpation, a traditional haptic ability, is used daily by practitioners of all medical and surgical specialties to assess patients. In the current study, one of the authors, in a routine clinical setting, was able to deduce the dynamic features of the putative inferior belly of omohyoid. This led to a proof-of-concept study that yielded results consistent with the clinical findings. METHODS The first part of the study involved a survey of 300 rheumatic disease patients in whom the greater supraclavicular fossa was explored by palpation. While the patient kept the head straight, the clinician placed his middle three fingers 2.5-3 cm dorsal to the clavicle in the window between the sternocleidomastoid and trapezius clavicular insertions, explored the supraclavicular fossa, and palpated the paired contractile inferior belly of the assumed omohyoid during flexion in the three orthogonal planes. In the second part of the study, five normal subjects were examined in a similar manner by the same clinician and had independent ultrasonography performed on the dominant side. Descriptive statistics were used, and Yates' corrected chi-squared test was applied to certain nominal variables. Additionally, a comparative anterolateral bilateral neck dissection was performed in a cadaveric specimen. RESULTS Both studies showed that the contractile structure was the inferior belly of omohyoid and that its contraction occurred during anterior neck flexion and was opposite to the side of neck rotation, resembling the sternocleidomastoid. CONCLUSIONS Palpation uncovered a previously unknown function of the inferior belly of omohyoid, suggesting that physical examination of the musculoskeletal system based on palpation may lead to hypotheses worthy of exploration.
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Affiliation(s)
- Juan J. Canoso
- Department of Medicine, ABC Medical Center, Mexico City 05348, Mexico;
- Division of Rheumatology, Tufts University School of Medicine, Boston, MA 02111, USA
| | - José Alvarez Nemegyei
- Rheumatology, Star Medical Hospital, Mérida 97130, Mexico; (J.A.N.); (J.G.A.A.); (R.A.K.)
| | - Esperanza Naredo
- Department of Rheumatology and Bone and Joint Research Unit, IIS Fundación Jiménez Díaz, Hospital Universitario Fundación Jiménez Diaz, 28040 Madrid, Spain; (E.N.); (O.O.V.)
- Department of Medicine, Universidad Autónoma de Madrid, 28049 Madrid, Spain
| | - Jorge Murillo González
- Department of Anatomy and Embryology, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain;
| | - José Ramón Mérida Velasco
- Department of Anatomy and Embryology, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain;
| | | | - Otto Olivas Vergara
- Department of Rheumatology and Bone and Joint Research Unit, IIS Fundación Jiménez Díaz, Hospital Universitario Fundación Jiménez Diaz, 28040 Madrid, Spain; (E.N.); (O.O.V.)
| | | | - José Eduardo Navarro Zarza
- Departamento de Medicina Interna y Reumatología, Hospital General de Chilpancingo Gro. Dr. Raymundo Abarca Alarcón, Chilpancingo 39016, Mexico;
| | - Robert A. Kalish
- Rheumatology, Star Medical Hospital, Mérida 97130, Mexico; (J.A.N.); (J.G.A.A.); (R.A.K.)
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Zhang ML, Guo LM, Li PC, Zhang JK, Guo CX. An effective method to reduce lymphatic drainage post-lateral cervical lymph node dissection of differentiated thyroid cancer: a retrospective analysis. World J Surg Oncol 2022; 20:294. [PMID: 36104741 PMCID: PMC9472435 DOI: 10.1186/s12957-022-02759-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 08/27/2022] [Indexed: 11/10/2022] Open
Abstract
Background Lymph or chyle leak (LL/CL) is severe complications after lateral cervical lymph node dissection (LLND), mainly due to iatrogenic injury of the lymphatic duct. Efficient and well-operated methods to reduce postoperative drainage are still lacking. This was a feasibility study to evaluate a new method of preventing LL/CL compared to conventional treatment. Method We retrospectively analyzed 20 consecutive patients who used the “pedicled omohyoid flap covering (POFC)” method during LLND from January 2019 to December 2021 in our center as an observation group. Another 20 consecutive patients used the conventional method during LLND in this period as a control group. The clinical and pathological features of the two groups were compared, and the related factors that affected postoperative lymphatic drainage were analyzed with Cox proportional hazards models. Results The drainage volume per 24 h and the incidence of LL/CL in the control group were both higher than that in the observation group (all P < 0.05), and the number of lymph nodes dissected in the IV region > 10 and the use of the POFC method were the independent risk factors that significantly affected the incidence of LL/CL post LLND (all P < 0.05). Conclusions POFC is a safe and useful method for reducing drainage and preventing LL/CL post-LLND, especially for patients with heavy metastasis of the lymph nodes in the IV region.
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Yang Y, Wang X, Mao W, He T, Xiong Z. Anatomical relationship between the omohyoid muscle and the internal jugular vein on ultrasound guidance. BMC Anesthesiol 2022; 22:181. [PMID: 35698062 PMCID: PMC9190082 DOI: 10.1186/s12871-022-01723-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 06/03/2022] [Indexed: 11/10/2022] Open
Abstract
Background Internal jugular vein catheterization is widely used in clinical practice, and there are many related studies on internal jugular vein catheterization. However, the omohyoid muscle, which is adjacent to the internal jugular vein, is a rarely mentioned muscle of the infrahyoid muscles group. The purpose of this study is to explore the anatomical relationship between the omohyoid muscle and the internal jugular vein on ultrasound guidance and provide a theoretical reference for jugular puncture and catheterization. Methods The study included 30 volunteers. The volunteer’s head lay in the neutral position and was then turned to the left at an angle of 30°, 45° and 60° with the bed surface, as verified using an adjustable protractor. A high-frequency ultrasound probe (6–14 Hz) was used to examine the plane of the apex of sternocleidomastoid triangle (PAST), the triangle consists of anatomical landmarks: a base was clavicle, its sides – heads of sternocleidomastoid muscle. And the plane of the middle of sternocleidomastoid triangle(PMST) which was a horizontal line, connecting midpoints of both sides. The right omohyoid muscle (OM) and the right internal jugular vein (IJV) were observed and recorded for statistical analysis. Results There were statistically significant differences in the number of overlapping cases of OM and IJV at each head rotation angle between the PAST and PMST groups. There were statistically significant differences between the angles which OM and IJV centre point line and the left horizontal position of the PAST and PMST at different body angles. Conclusion The traditional middle route puncture point is the apex of the sternocleidomastoid triangle, which can effectively avoid injury to the omohyoid muscle, to an extent. Trail registration ChiCTR2000034233, Registered 29/06/2020. www. Chinese Clinical Trial Registry.gov.
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Affiliation(s)
- Yun Yang
- Department of Anesthesiology, the First People's Hospital of Huzhou, the Affiliated Hospital of Huzhou Teachers College, Guangchanghou Road 158th, 313000, Huzhou, People's Republic of China
| | - Xinqiang Wang
- Department of Anesthesiology, the First People's Hospital of Huzhou, the Affiliated Hospital of Huzhou Teachers College, Guangchanghou Road 158th, 313000, Huzhou, People's Republic of China
| | - Weiliang Mao
- Department of Anesthesiology, the First People's Hospital of Huzhou, the Affiliated Hospital of Huzhou Teachers College, Guangchanghou Road 158th, 313000, Huzhou, People's Republic of China
| | - Tongyun He
- Department of Anesthesiology, the First People's Hospital of Huzhou, the Affiliated Hospital of Huzhou Teachers College, Guangchanghou Road 158th, 313000, Huzhou, People's Republic of China
| | - Zhaodong Xiong
- Department of Anesthesiology, the First People's Hospital of Huzhou, the Affiliated Hospital of Huzhou Teachers College, Guangchanghou Road 158th, 313000, Huzhou, People's Republic of China.
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