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Tong JY, Gocal WA, Haft SJ. Adverse events associated with device assisted hyoid and tongue base suspension for obstructive sleep apnea. Am J Otolaryngol 2024; 45:104237. [PMID: 38479218 DOI: 10.1016/j.amjoto.2024.104237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 02/21/2024] [Accepted: 02/21/2024] [Indexed: 05/07/2024]
Abstract
PURPOSE Hyoid and tongue base suspension may treat obstructive sleep apnea (OSA). This study summarizes device-related adverse events associated with the AIRvance and AIRLIFT systems used for hyoid and tongue base suspension. MATERIALS AND METHODS The U.S. Food and Drug Administration's Manufacturer and User Facility Device Experience (MAUDE) database was queried for reports describing adverse events associated with hyoid or tongue base suspension from January 2012 to December 2022. RESULTS 77 adverse events were identified. When performed separately, adverse events were equally as common with hyoid suspension as with tongue base suspension. More complications occurred postoperatively (51 [66.2 %]) than intraoperatively (26 [33.8 %]). The most reported adverse events were infection (23 [29.9 %]), broken screw (15 [19.5 %]), pain or discomfort (10 [13.0 %]), suture rupture (8 [10.4 %]), and dislodged screw (7 [9.1 %]). 10 infections required drainage or debridement; 12 required device explantation. CONCLUSIONS The present study is the largest and most longitudinal review of adverse events associated with hyoid and tongue base suspension. Infection was the most common adverse event, and may require device explantation. While adverse events were most frequently attributed to device malfunction, broken screw, suture rupture, and broken needle were often attributed to operator error due to application of excessive force. Surgeon training to increase familiarity with hyoid and tongue base suspension may reduce adverse events caused by operator error. The MAUDE database is limited as a passive surveillance system. Standardized reporting may improve understanding of associated adverse events, enabling better informed comparisons between surgical treatment options for OSA.
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Affiliation(s)
- Jane Y Tong
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Maryland, School of Medicine, Baltimore, MD, United States of America
| | - Wiktoria A Gocal
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Maryland, School of Medicine, Baltimore, MD, United States of America
| | - Sunny J Haft
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Maryland, School of Medicine, Baltimore, MD, United States of America.
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Oh J, Han SI, Lim SC. Intraosseous hemangioma with aneurysmal bone cyst-like changes of the hyoid bone: Case report and literature review. Medicine (Baltimore) 2024; 103:e37137. [PMID: 38335421 PMCID: PMC10860961 DOI: 10.1097/md.0000000000037137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 01/01/2024] [Accepted: 01/11/2024] [Indexed: 02/12/2024] Open
Abstract
RATIONALE Intraosseous hemangioma is a rare benign vascular tumor of the bone that can affect any body part; however, the most common site is the vertebra, followed by calvarial bones. PATIENT CONCERNS We present a case of intraosseous hemangioma in a 23-year-old male who presented a feeling of fullness in the throat for 3 months. The hyoid bone level had a hard mass of about 5 cm. Fine needle aspiration showed 5 mL dark bloody aspirates. Magnetic resonance image showed a 5.3 cm mixed signal intensity lesion in the hyoid body. DIAGNOSIS Histopathologic examination showed intraosseous hemangioma with aneurysmal bone cyst (ABC)-like changes in the hyoid bone. INTERVENTIONS The mass was completely removed without significant problems. OUTCOMES Complete mass excision and symptomatic improvements were achieved, and no subsequent relapses were observed. LESSONS The authors experienced a case of intraosseous hemangioma with ABC-like changes. There has been no case report of intraosseous hemangioma in the hyoid bone. This case showed a spectral pattern of the ABC-like changes developing from the underlying bone tumor as a secondary change. ABC-like changes in bone tumors can mislead the diagnosis. Careful examination of the tumor is essential for the correct diagnosis of ABC or ABC-like changes.
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Affiliation(s)
- Jeonghyun Oh
- Department of Otorhinolaryngology, Chosun University, Gwangju, Korea
| | - Song Iy Han
- Division of Premedical Science, Chosun University, Gwangju, Korea
| | - Sung-Chul Lim
- Department of Pathology, College of Medicine, Chosun University, Gwangju, Korea
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Karino M, Sonoyama R, Ishizuka S, Toda E, Okuma S, Matsuda Y, Tatsumi H, Okui T, Kanno T. [Effect of the Hyoid Bone Suspension Technique on the Preservation of Swallowing Function after Total Glossectomy and Pectoralis Major Musculocutaneous Flap Reconstruction for Locally Advanced Tongue Cancer]. Gan To Kagaku Ryoho 2023; 50:1934-1937. [PMID: 38303257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
Dysphagia is a major postoperative complication in patients with locally advanced oral cancer. In this case report, we describe the effect of the hyoid bone suspension technique on the preservation of swallowing function after total glossectomy and pectoralis major musculocutaneous flap reconstruction for locally advanced tongue cancer. Case: A 72-year-old Japanese male was diagnosed with advanced squamous cell carcinoma on the left side of his tongue(cT4aN2cM0, cStage ⅣA). Under general anesthesia, the patient underwent a tracheotomy, bilateral modified radical neck dissection type Ⅲ, total glossectomy, and reconstruction with a left pectoralis major musculocutaneous flap(PMMC flap). Intraoperatively, the PMMC flap was designed to have a heart shape of 11×6 cm and was elevated. Subsequently, holes were made at the lower edge of the mandible, and the hyoid bone was suspended and fixed to the mandibular border using 2-0 nylon sutures. The postoperative course was uneventful; the flap was completely engrafted and was in good condition. The hyoid bone suspension technique can reproduce the pharyngeal phase of swallowing, and the palatal augmentation prosthesis helps to improve food mass feeding and preserve the swallowing function.
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Affiliation(s)
- Masaaki Karino
- Dept. of Oral and Maxillofacial Surgery, Shimane Prefectural Central Hospital
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Ogisawa S, Nishikubo S, Nakajima J, Azaki H, Mayahara K, Shinozuka K, Tonogi M. The changes in oral volume and hyoid bone position after maxillomandibular advancement and genioglossus advancement for patients with obstructive sleep apnea. Sleep Breath 2023; 27:239-244. [PMID: 35380343 DOI: 10.1007/s11325-022-02600-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 02/16/2022] [Accepted: 03/16/2022] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Maxillomandibular advancement (MMA) and genioglossus advancement (GA) are surgeries for patients with obstructive sleep apnea (OSA). Postoperative evaluation is primarily based on the apnea-hypopnea index (AHI) measured by polysomnography. The purpose of this study was to identify the timing of hyoid bone relocation after MMA and GA surgery and to investigate whether or not hyoid bone relocation can be an indicator of postoperative evaluation of OSA. METHODS Patients with OSA underwent MMA and GA surgery. Changes in hyoid bone position and tongue-to-oral volume ratio were analyzed on lateral radiographs before, immediately after, and 1 year after surgery. Then, a correlation was verified between these changes and postoperative AHI. RESULTS In 18 patients studied, the position of the hyoid bone did not show a constant tendency immediately after surgery. One year after surgery, the bone had moved anteriorly and toward the oral cavity in all patients compared to its preoperative position. And AHI correlated with the movement of the hyoid bone to the oral side. DISCUSSION One year after surgery, the tongue was adapted to the newly enlarged oral space, and as a result, the low position of the hyoid bone before the operation was improved. The findings suggest that the degree of lowering of the hyoid bone may be an indicator of the improvement of AHI.
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Affiliation(s)
- Shouhei Ogisawa
- First Department of Oral and Maxillofacial Surgery, Nihon University School of Dentistry, 1-8-13, Kanda-Surugadai, Chiyoda-ku, Tokyo, 101-8310, Japan
| | - Shuichi Nishikubo
- First Department of Oral and Maxillofacial Surgery, Nihon University School of Dentistry, 1-8-13, Kanda-Surugadai, Chiyoda-ku, Tokyo, 101-8310, Japan.
| | - Junya Nakajima
- First Department of Oral and Maxillofacial Surgery, Nihon University School of Dentistry, 1-8-13, Kanda-Surugadai, Chiyoda-ku, Tokyo, 101-8310, Japan
| | - Hiroaki Azaki
- First Department of Oral and Maxillofacial Surgery, Nihon University School of Dentistry, 1-8-13, Kanda-Surugadai, Chiyoda-ku, Tokyo, 101-8310, Japan
| | - Kotoe Mayahara
- Department of Orthodontics, Nihon University School of Dentistry, 1-8-13, Kanda-Surugadai, Chiyoda-ku, Tokyo, 101-8310, Japan
| | - Keiji Shinozuka
- First Department of Oral and Maxillofacial Surgery, Nihon University School of Dentistry, 1-8-13, Kanda-Surugadai, Chiyoda-ku, Tokyo, 101-8310, Japan
| | - Morio Tonogi
- First Department of Oral and Maxillofacial Surgery, Nihon University School of Dentistry, 1-8-13, Kanda-Surugadai, Chiyoda-ku, Tokyo, 101-8310, Japan
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Godinho GV, Da Silva EJ, Da Silva CAL, Volpato LER. Epidermoid cyst mimicking a thyroglossal duct cyst in a pediatric patient: a case report. Gen Dent 2022; 70:61-64. [PMID: 34978993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This article presents a case of an epidermoid cyst that mimicked a thyroglossal duct cyst in a pediatric patient. An 8-year-old boy was referred for evaluation of a volumetric increase in the median cervical region with an evolution of about 4 years. The skin in the submental region was healthy and normal colored. Palpation revealed a mobile, well-circumscribed nodular lesion of soft consistency. Computed tomography of the neck showed an expansive hypodense formation extending from the base of the tongue to the upper portion of the hyoid bone, suggesting a thyroglossal duct cyst. Considering the diagnostic hypothesis, cystic enucleation via the Sistrunk procedure was planned. However, no ductal structure was identified during the surgical procedure, and the lesion was only near, but not attached to, the hyoid bone. Simple excision of the lesion was therefore performed. At the most recent follow-up examination, about 3 months postoperatively, the patient demonstrated satisfactory clinical progress. The epidermoid cyst close to the hyoid bone presented diagnostic difficulty due to its similarity to a thyroglossal duct cyst. Computed tomography provides limited information for diagnosing this type of lesion, and ultrasonography is the preferred test. In view of the uncertain diagnosis in this case, the extent of the excision was determined during the surgery, and simple excision was a satisfactory treatment associated with a good prognosis.
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Chen S, Wang D, Qiu J, Liu Y, Zhao Y. Endoscopic-Assisted Transoral Thyroglossal Cyst Resection. Front Endocrinol (Lausanne) 2021; 12:774174. [PMID: 35250846 PMCID: PMC8894260 DOI: 10.3389/fendo.2021.774174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 12/30/2021] [Indexed: 11/29/2022] Open
Abstract
Sistrunk procedure is the standard method for thyroglossal duct cyst resection. While this procedure is successful and safe, it results in postoperative scars on the front of neck. We propose a total transoral technique without external incision that starts with careful separation of the floor of the mouth and genioglossus muscle followed by the exact localization of the cyst using methylene blue. Simultaneously, the hyoid bone connected to the cyst and tract was removed. Finally, routine hemostasis is conducted, and the operative cavity is closed. All patients who received this operation in our department recovered successfully without experiencing severe intraoperative or postoperative complications.
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Pardi V, Bertocchini A, Aloi IP, Frediani S, Martucci C, Inserra A. Electrocautery only for hyoid bone removal in pediatric thyroglossal duct cyst excision. Ann Ital Chir 2020; 91:688-691. [PMID: 33554940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
AIM Surgical excision of hyoid bone is the mainstay of thyroglossal duct cyst removal, to prevent recurrences. Bone excision by cut - bone forceps may prove inaccurate and somewhat dangerous. Therefore, use of alternative methods has been advocated. MATERIAL AND METHODS The proposal of the study is to cut the body of the hyoid bone with the only electric scalpel. Surgical casenotes of 57 pediatric patients operated by our Institution with modified Sistrunk technique and complete dissection of the entire body of hyoid bone and its removal at the cartilage junction with lateral horn with monopolar cauterization were reviewed. RESULTS The population of our study had a mean age of 59.86 ± 29.57 months; 6/57 patients (10.5%) were under 2 years of age. Mean follow up was 55,04 ± 29,08 months ranging 2 to 115 months. In any patients post-operative bleeding was observed. Mean surgical time was 57,02 ± 11,77 minutes ranging from 35 to 125 minutes; 6 cases required postoperative drain. In 3 patients an immediate local edema was observed and in another one a partial wound dehiscence occurred, no late complications were observed. Cyst-recurrence requiring re-do surgery occurred in 5 patients (8.8%). CONCLUSIONS The complete hyoid bone section with electric scalpel only ensures the ideal access to the posterior hyoid space and allows a greater and more symmetrical access to the proximal portion of thyroglossal duct in children with still negligible complication and recurrence rate. KEY WORDS Modified Sistrunk technique, Sistrunk procedure, Thyroglossal duct cyst.
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Abstract
BACKGROUND Improvement of neck contour is a primary goal of patients who seek rejuvenation of the face and neck. Subplatysmal structures, including fat, the digastric muscle, and the submandibular salivary glands (SMSGs), may contribute to the appearance of a disproportionately large neck. OBJECTIVES The authors sought to evaluate the safety, effectiveness, and predictability of necklift combined with reshaping and repositioning of the subplatysmal structures. METHODS The records of 504 patients were reviewed retrospectively. Surgical maneuvers for subplatysmal necklift were described comprehensively and supplemented with videos. The subplatysmal anatomy was detailed by means of 2 cadaver dissections. RESULTS A total of 430 patients (85.3%) underwent subplatysmal necklift. The most commonly treated structures were fat (423 patients [83.9%]), the SMSGs (307 patients [60.9%]), and the digastric muscle (91 patients [18.1%]). The most common complications were weakness of the lower lip depressor (29 patients [5.7%]), followed by sialoma of the parotid gland (10 patients [2%]). No patients experienced subplatysmal hematoma. CONCLUSIONS Subplatysmal necklift is a safe, effective, and reliable option for patients who desire improved cervical contour. LEVEL OF EVIDENCE 4 Therapeutic.
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Affiliation(s)
- André Auersvald
- Drs A. Auersvald and L. Auersvald are plastic surgeons in private practice in Curitiba, Paraná, Brazil. Dr Uebel is a Professor and Chair of the Section of Plastic Surgery, Pontificia Universidade Católica do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Luiz A Auersvald
- Drs A. Auersvald and L. Auersvald are plastic surgeons in private practice in Curitiba, Paraná, Brazil. Dr Uebel is a Professor and Chair of the Section of Plastic Surgery, Pontificia Universidade Católica do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Carlos Oscar Uebel
- Drs A. Auersvald and L. Auersvald are plastic surgeons in private practice in Curitiba, Paraná, Brazil. Dr Uebel is a Professor and Chair of the Section of Plastic Surgery, Pontificia Universidade Católica do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
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Nicollas R, Mimouni O, Roman S, Triglia JM. Intralaryngeal Manifestation of Thyroglossal Duct Cyst. Otolaryngol Head Neck Surg 2016; 137:360-1. [PMID: 17666276 DOI: 10.1016/j.otohns.2007.03.019] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2007] [Accepted: 03/09/2007] [Indexed: 11/15/2022]
Affiliation(s)
- Richard Nicollas
- Department of Pediatric Otorhinolaryngology--Head and Neck Surgery, La Timone Children's Hospital, Marseille, France.
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Abstract
An atypically located thyroglossal duct cyst in a 42-year-old man is described. A purely intralaryngeal thyroglossal duct cyst is extremely rare and can mimic other laryngeal lesions. This case demonstrates that thyroglossal duct cyst is a possible cause of intralaryngeal swellings and would have significant implications for the manner in which they are managed.
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Affiliation(s)
- Woei Shyang Loh
- Dept of Otolaryngology, National University of Singapore, 5 Lower Kent Ridge Road, Singapore, Republic of Singapore 119074
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Abstract
Objectives: I performed a retrospective chart review to evaluate the patient tolerance and clinical results of a new technique for office-based vocal fold augmentation. Methods: Ten patients undergoing the thyrohyoid approach for vocal fold augmentation were asked to rate their tolerance of the procedure using a 10-point rating scale (1 = “no problem” and 10 = “very uncomfortable”). The patients also filled out a quality-of-life survey (Voice Handicap Index-10) immediately before and 1 month after the procedure. I reviewed the preprocedure and postprocedure stroboscopic findings. The findings analyzed included changes in wave symmetry and glottal closure, and evidence of implant migration. Results: All patients successfully underwent the procedure. The mean patient tolerance score was found to be 2.1. The average score on the Voice Handicap Index-10 improved from 21.3 before the procedure (SD, 9.23) to 7.5 after the procedure (SD, 5.77). These values were compared by use of a paired t-test, and the difference was found to be significant, with a p value of .01. The analysis of stroboscopic results revealed “improvement” or “no change” in the wave symmetry, “improvement” in glottal closure, and “no evidence of migration” after the procedure in all cases. Conclusions: The study findings demonstrate that the thyrohyoid approach can be used successfully in patients who need vocal fold augmentation, and that it is generally well tolerated.
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Affiliation(s)
- Milan R Amin
- New York University Voice Center and the Department of Otolaryngology, Division of Laryngology, New York University School of Medicine, New York, New York 10016, USA
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Verse T, Baisch A, Maurer JT, Stuck BA, Hörmann K. Multilevel Surgery for Obstructive Sleep Apnea: Short-Term Results. Otolaryngol Head Neck Surg 2016; 134:571-7. [PMID: 16564374 DOI: 10.1016/j.otohns.2005.10.062] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2004] [Accepted: 10/24/2005] [Indexed: 10/24/2022]
Abstract
OBJECTIVE: To determine the efficacy of a new multilevel surgical protocol for obstructive sleep apnea (OSA). STUDY DESIGN AND SETTING: Sixty patients with moderate to severe OSA because of multilevel pharyngeal obstruction were enrolled into this prospective, controlled clinical trial after clinical examination, endoscopy, and polysomnography. Surgery included uvulaflap, tonsillectomy, hyoid suspension, and radiofrequency treatment of the tongue base (group A). A second group did not receive hyoid suspension (group B). In both groups, nasal surgery was performed if necessary. Polysomnography and Epworth Sleepines Scale (ESS) were recorded at baseline and 2 to 15 months after surgery. RESULTS: In group A, the mean apnea-hypopnea index (AHI) decreased significantly after surgery (38.9 ± 20.0 vs 20.7 ± 20.6, P < 0.0001), whereas in group B the AHI did not. All secondary variables (minimal oxygen saturation, mean oxygen saturation, arousal index), and the ESS significantly improved in group A with only changes in arousal index and ESS reaching levels of significance in group B. CONCLUSION: The presented protocol including the hyoid suspension proved to be effective in the treatment of OSA, whereas surgery without hyoid suspension was less successful.
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Affiliation(s)
- Thomas Verse
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Mannheim, Mannheim, Germany
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Stuck BA, Neff W, Hörmann K, Verse T, Bran G, Baisch A, Düber C, Maurer JT. Anatomic Changes After Hyoid Suspension for Obstructive Sleep Apnea: An MRI Study. Otolaryngol Head Neck Surg 2016; 133:397-402. [PMID: 16143189 DOI: 10.1016/j.otohns.2005.06.002] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2004] [Accepted: 06/01/2005] [Indexed: 11/17/2022]
Abstract
OBJECTIVE: To assess the effects of isolated hyoid suspension on subjective and objective parameters of obstructive sleep apnea and to evaluate changes in upper airway anatomy with the help of standardized magnetic resonance imaging. STUDY DESIGN AND SETTING: Fifteen patients received isolated hyoid suspension. Changes in respiratory disturbance index were assessed with polysomnography, and anatomical changes with standardized magnetic resonance imaging. Snoring, daytime sleepiness, and functional parameters were assessed with questionnaires. Lateral x-ray cephalometry was performed preoperatively. RESULTS: Mean respiratory disturbance index was reduced from 35.2 ± 19.1 to 27.4 ± 26.2. Forty percent of the patients were classified as responders. Daytime sleepiness improved significantly. Relevant changes in upper airway anatomy could not be detected. There were no remarkable differences between responders and nonresponders in regard to imaging. CONCLUSIONS: Hyoid suspension is effective only in a subgroup of patients and does not lead to relevant changes in airway diameters in the awake patient. Magnetic resonance imaging and x-ray cephalometry do not add additional information for patient selection. SIGNIFICANCE: The reported clinical effects of hyoid suspension are more likely due to functional changes in airway collapsibility than to an enlargement of the upper airway.
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Affiliation(s)
- Boris A Stuck
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Mannheim, Germany.
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Yin SK, Yi HL, Lu WY, Guan J, Wu HM, Cao ZY. Genioglossus advancement and hyoid suspension plus uvulopalatopharyngoplasty for severe OSAHS. Otolaryngol Head Neck Surg 2016; 136:626-31. [PMID: 17418263 DOI: 10.1016/j.otohns.2006.01.028] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2005] [Accepted: 01/18/2006] [Indexed: 11/19/2022]
Abstract
Objective To evaluate the outcome of a comprehensive surgical approach on the treatment of severe obstructive sleep apnea hypopnea syndrome (OSAHS) and find out possible predictors to the effectivenss of this approach. Study Design And Setting Eighteen patients received genioglossus advancement with hyoid suspension (GAHM) and uvulopalatopharyngoplasty (UPPP). The multiple logistic regression was used to analyze predictors for the outcome of treatment. Results Apnea hypopnea index (AHI) showed a reduction in the preoperative vs postoperative polysomnography (63.83 ± 16.34 vs 21.43 ± 20.34). With success defined as a final postoperative AHI of less than 20 events per hour, the success rate was 67%. The main differences between responders and nonresponders include age, posterior airway space (PAS), time of oxyhemoglobin saturation below 90% (CT90), and body mass index (BMI). Age and BMI were key predictors for therapeutic effect. Conclusion GAHM plus UPPP may benefit severe OSAHS patients with oropharyngeal and hypopharyngeal obstruction. The success was best predicted by low BMI and younger age. Significance This paper provides reference for patient selection of UPPP plus GAHM, and considers that older or morbidly obese patients with OSAHS should be excluded from this operation.
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Affiliation(s)
- Shan Kai Yin
- Department of Otolaryngology, Affiliated Shanghai Sixth People's Hospital of Shanghai Jiao Tong University, Shanghai, China.
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Baisch A, Maurer JT, Hörmann K. The Effect of Hyoid Suspension in a Multilevel Surgery Concept for Obstructive Sleep Apnea. Otolaryngol Head Neck Surg 2016; 134:856-61. [PMID: 16647548 DOI: 10.1016/j.otohns.2006.01.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2005] [Indexed: 11/18/2022]
Abstract
OBJECTIVE: This study investigated the outcome of the hyoid suspension as a part of a multilevel surgery protocol. STUDY DESIGN AND SETTING: Eighty-three patients with obstructive sleep apnea (OSA) underwent a multilevel surgical treatment because of continuous positive-airway pressure intolerance, 67 with the hyoid suspension and 16 without the hyoid suspension. All patients underwent a pre- and postoperative polysomnography in the sleep laboratory. RESULTS: The mean preoperative apnea hypopnea index (AHI) was 36.4 ± 21.2 and 19.4 ± 19.7 postoperatively for all patients ( P < 0.0001). Further statistically significant changes were found for the arousal index, the oxygen saturation, and the daytime sleepiness. No statistically significant change was found for body mass index. In the group of patients treated without the hyoid suspension, the AHI did not decrease statistically significant. After surgery, 59.7% of the subjects with the hyoid suspension were regarded as cured. CONCLUSION: Multilevel surgery including the hyoid suspension is an effective treatment in subgroup of OSA patients. EBM rating: C-4
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Affiliation(s)
- Alexander Baisch
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Mannheim, Mannheim, Germany.
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Amaral D, Zagalo C, Cardina C, Vera-Cruz P. Chondrosarcoma of the hyoid bone: Case report and review of the literature. Rev Laryngol Otol Rhinol (Bord) 2015; 136:77-80. [PMID: 27483580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
INTRODUCTION Chondrosarcomas are cartilaginous tumors that range from low-grade tumors with low metastatic potential to high-grade aggressive tumors with premature and high metastatic rate. Low-grade types have few karyotype abnormalities and are near-diploid, while high-grade chondrosarcomas originate from complex karyotypes and are aneuploid. The most common karyotype aberrations found include 12q13-15 and 9p21 rearrangements. Here, it is presented a case of chondrosarcoma of the hyoid bone with its image, surgical procedure and pathological correlation as well as a review of the literature. CASE PRESENTATION A sixty-three year old man presented with a large cervical mass located at submental level. The CT scan revealed a voluminous and well-limited mass of 5 x 4 x 3 cm located in the suprahyoid region. The operative finding revealed a grade 2 chondrosarcoma originating from the hyoid bone. DISCUSSION Chondrosarcoma of the. hyoid bone is a rare pathology, thus making it difficult to diagnose. Fine needle biopsies have high diagnostic accuracy, although correct grading is only obtained 46% of the time. CT scan is the golden standard to characterize tumor extension and origin. Surgical excision is the treatment of choice for chondrosarcoma.
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Kubota H, Sanada Y, Yoshioka H, Tasaki T, Shiroma J, Miyauchi M, Tanikawa R, Matsuki M, Ohtsuki T, Kato A. C1 transverse process-hyoid bone line for preoperative evaluation of the accessible internal carotid artery on carotid endarterectomy: technical note. Acta Neurochir (Wien) 2015; 157:43-8. [PMID: 25319342 DOI: 10.1007/s00701-014-2253-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 10/03/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND The preoperative imaging diagnosis of the distal portion of the internal carotid artery (ICA) is extremely important for carotid endarterectomy (CEA). Herein the authors defined a line from the C1 transverse process to the hyoid bone (C1-H line) and evaluated whether the line can be used to predict an accessible ICA in CEA. METHODS A cross point between the C1-H line and distal ICA was analyzed using three-dimensional computerized tomographic angiography (3D-CTA) in 20 patients. The C1-H line was compared to the line drawn from the mastoid process to the mandible (M-M line). Intraoperative exposure of the distal ICA was evaluated using both lines. Furthermore, the distance of each line from the C2 vertebra was measured to identify the distance difference of each line in relation to the cervical posture. RESULTS A distal ICA exposed at a cross point of the C1-H line corresponded well with the intraoperative findings. The cross point between the C1-H line and distal ICA was positioned at an average of 7.0 ± 0.7 mm cranially in comparison to the M-M line. The C1-H line showed smaller distance differences at different cervical positions than the M-M line. The C1-H line moved an average of 2.8 ± 2.5 mm from a cervical neutral position to an extensional one in the perpendicular direction. CONCLUSION The C1-H line measured by 3D-CTA is a simple and useful indicator of the distal ICA exposure in the preoperative diagnosis for CEA.
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Affiliation(s)
- Hisashi Kubota
- Department of Neurosurgery, Kinki University Faculty of Medicine, 377-2, Onohigashi, Osakasayama, Osaka, 589-8511, Japan,
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Abstract
BACKGROUND Ectopic thyroid tissue is a relatively rare condition and a developmental anomaly characterized by the aggregation of thyroid tissue. Usually, it occurs along the path of descent of the developing thyroid primordium from the foramen caecum, the most common being in the anterior midline of the neck at or below the level of the hyoid bone. Surgical removal of ectopic thyroid tissue is usually accomplished through an external incision in the neck. However, this procedure inevitably results in a neck scar. METHODS We report the case of a 30-year-old woman with ectopic thyroid tissue. We implemented a modified approach to ectopic thyroid tissue removal through a frenotomy incision of the mouth using an endoscope system. RESULTS A modified approach to ectopic thyroid tissue removal was used in this patient. The total operative time was 50 minutes, and the patient remains free of disease 15 months after excision. CONCLUSION Resection of ectopic thyroid tissue can be performed by a transoral endoscope-assisted approach through a frenotomy incision of the mouth.
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Affiliation(s)
- Seung Hoon Woo
- Department of Otolaryngology, Gyeongsang National University , Jinju, Korea
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Ouyang D, Yang AK, Zhang Q, Chen WK, Song M, Li H, Liu WW, Liu XK, Chen YF, Li QL, Chen WC, Yang ZY, Zhang X, Chen SW, Guo ZM. [Laryngeal reconstruction by complex hyoid bone flap after frontal partial laryngectomy]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2013; 48:340-343. [PMID: 23886100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVE The aim of this study was to describe a new technique of combined hyoid bone and thyrohyoid membrane flap in laryngeal reconstruction after tumor resection, and to evaluate outcome. METHODS Six patients requiring an frontal partial laryngectomy for cancer were enrolled between September 2008 and August 2012. RESULTS Nasogastric feeding was initiated within 24 hours. The mean times to swallow batter, ability to drink water and removal of the nasogastric tube were 2.6, 5.5 and 6.3 days. All patients had good respiratory function. There were no deaths, and no reports of postoperative dyspnea or dysphagia. The vocal quality was satisfactory, slightly deeper and raspy, and the volume was weak when calling. The final follow-up assessment was in August 2012, and the overall mean follow-up period was 29.5months, range 14 to 47 months. Case two subsequently underwent total laryngectomy for recurrence in the paraglottic space, but there was no evidence of further tumor recurrence at the final assessment. CONCLUSIONS The combined muscle-pedicle hyoid bone and thyrohyoid membrane flap is a reliable graft for one-stage repair of laryngotracheal defects, providing effective repair of the mucosa and cartilage support. Vocal quality, swallowing function and ventilation after the procedure were favorable.
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Affiliation(s)
- Dian Ouyang
- Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center, Key Laboratory of Oncology in Southern China, Guangzhou 510060, China
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Berntsen M, Bork K, Sørensen CH. [Hyoid bone tumour]. Ugeskr Laeger 2012; 174:2085. [PMID: 22944330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Karataylı-Özgürsoy S, Demireller A. Hyoid suspension surgery with UPPP for the treatment of hypopharyngeal airway obstruction in obstructive sleep apnea. Ear Nose Throat J 2012; 91:358-364. [PMID: 22930085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
We report our experience with hyoid suspension surgery in patients with obstructive sleep apnea (OSA) diagnosed on the basis of polysomnographic criteria. We conducted a prospective, observational study of 20 patients--18 males and 2 females, aged 15 to 52 years (mean: 42.1)--who were treated at our tertiary care center. All patients underwent hyoid suspension surgery and uvulopalatopharyngoplasty (UPPP) in a single session. Postoperative success was defined as either (1) a reduction in the apnea-hypopnea index (AHI) from 20 or higher to less than 20 or (2) a reduction in AHI of at least 50%. Postoperative follow-up polysomnography indicated that surgery was successful in 18 of 20 patients (90%). No important complications were observed. We conclude that hyoid suspension surgery is an effective procedure with low morbidity for the treatment of OSA in selected patients with hypopharyngeal obstruction. We believe it is a good option for those patients who will not or cannot tolerate therapy with continuous positive airway pressure.
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Liu F, He X, Li Y, Wang F. [Compare the results of supracricoid partial laryngectomy-cricohyoidopexy and horizontal-vertical hemilaryngectomy in the treatment of mid and late laryngeal carcinoma]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2012; 26:673-677. [PMID: 23167175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To compare the results of supracricoid partial laryngectomy-cricohyoidopexy (SCPL-CHP) and horizontal-vertical hemilaryngectomy in the treatment of mid and late laryngeal carcinoma. METHOD Retrospective analysis on the types of mid and late stage of laryngeal carcinoma clinical material, 22 patients supracricoid partial laryngectomy-cricohyoidopexy, 20 patients horizontal-vertical hemilaryngectomy, each with the added radiotherapy. The long term results of operation and glottic reconstruction were evaluated by postoperative visiting, semi-quantitative speech intelligibility analysis, electroglottograph (EGG) and so on. RESULT Forty-two cases of laryngeal cancer patients were decannulated, the decannulation rate was 100%. Postoperative decannulation time: surgical CHP for (44.0 +/- 4.6) d, 3/4 throat operation for (39.0 +/- 2.7) d, two groups of postoperative decannulation time difference was statistically significant (t = 4.2395, P < 0.01). Eight weeks after evaluation, two groups's swallowing function and postoperative evaluation of patients after one year speech intelligibility difference was not statistically significant (P > 0.05). GRBAS in the evaluation of G rating, the difference between the two groups was statistically significant (P < 0.05), CHP group showed,for most patients, a severe hoarse degree, but 3/4 throat operation group mainly represented a moderate degree lever. EGG parameters were checked after 1 years. F0 comparative differences was not statistically significant (P > 0.05), and the jitter, shimmer and NNE compared CHP group to 3/4 laryngectomy group were significantly increased (P < 0.05). Kaplan-Meier method statistics show: CHP group and 3/4 laryngectomy group 3 years and 5 year accumulate survival rates were 95.5% and 89.7%, 85.1% and 83.7% respectively, two groups of three, five years of survival difference was not statistically significant (P > 0.05). CONCLUSION According to the laryngeal of middle-late carcinoma, the region and the involvement of the scope were considered to choose appropriate surgical treatments, and both can complete resection of the tumor, and can retain good laryngeal functions,and CHP has a wider range of operation indications and clinical application prospect, is worthy to be popularized.
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Affiliation(s)
- Fanli Liu
- Department of Otorhinolaryngology, the Second Affiliated Hospital of Wenzhou Medical College, Wenzhou, 325000, China
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Chen JH, Luo ZH, Yang R, Kang J, Wang YP, Yang XL, Zhu MW, Tao ZZ. [Complications of hyoid suspension with Repose system on obstructive sleep apnea hypopnea syndrome]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2012; 47:449-453. [PMID: 22932134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To investigate the complications of hyoid suspension with Repose system on obstructive sleep apnea hypopnea syndrome (OSAHS) and to find out the effective prevention strategies. METHODS Forty four patients diagnosed by polysomnography as OSAHS were received hyoid suspension with Repose system from June 2005 to July 2009. The intraoperative and postoperative complications were analyzed retrospectively. The patients who reported abnormal swallowing were evaluated with water drinking test and video fluorography swallow study to assess biomechanical changes in swallowing. RESULTS Incidence rate of perioperative titanium nial amotio was 15.9% (7/44). It was avoided by implanting titanium nial again. No perioperative complications occurred such as injury of superior laryngeal nerve, blood vessel and thyrohyoid membrane, fracture of hyoid bone, suture break. All patients developed dysfunctions of pronunciation and swallowing, edema of mouth floor, dysfunctions of movement of tongue that could relieved gradually after three days on most patients. No postoperative complications occurred such as titanium nial amotio, fat liquoring, edema of mouth floor, hematoma, infection, foreign body reaction, injury of root apex of anterior tooth, dysfunctions of movement and sensation of tongue, suture break and death. All patients had over 2 year postoperative follow up. Incidence rate of dysfunctions of pronunciation and swallowing was 4.5% (2/44) and 15.9% (7/44) respectively. Main situation for dysfunctions of pronunciation was speaking ambiguity. Major manifestations of swallowing abnormalities were occasional aspiration, food going down the wrong tube, food becoming stuck in the throat, deglutition with bowing head. Seven patients who had abnormal swallowing possessed normal water drinking test and occurred asynersis of hyoid movement and laryngeal elevation, but aspiration were not observed. Three patients presented obvious stagnation in epiglottic vallecula and sinus piriformis. CONCLUSIONS Most complications of hyoid suspension with Repose system may be avoided or recovered on short term. Postoperative dysfunctions of pronunciation and swallowing may exist for a long time.
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Affiliation(s)
- Jin-hui Chen
- Sleep Disordered Breathing Center, Department of Otorhinolaryngology, Head and Neck Surgery, Renmin Hospital of Wuhan University, China
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Braun T, Reichel O. Snapping joint of the hyoid bone. J Otolaryngol Head Neck Surg 2012; 41:E1-E3. [PMID: 22498274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Affiliation(s)
- Thomas Braun
- Department of Otorhinolaryngology, Head and Neck Surgery, Ludwig Maximilian University, Munich, Germany.
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Crevier-Buchman L, Pillot-Loiseau C, Rialland A, Vincent C, Desjacques A. Analogy between laryngeal gesture in Mongolian Long Song and supracricoid partial laryngectomy. Clin Linguist Phon 2012; 26:86-99. [PMID: 21728836 DOI: 10.3109/02699206.2011.590920] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This article reports the results of a multiparametrical analysis of Mongolian Long Song, characterised by multiple ornamentation and shows the similarities between the laryngeal behaviour observed during these ornamentations and the compensatory gesture produced by patients after supracricoid partial laryngectomy. This study includes (1) a physiological analysis of videofiberscopic laryngeal data from a healthy Mongolian singer and from three non-singer French-speaking clinical patients; and (2) an acoustical analysis (fundamental frequency and intensity). For the singer, the fiberoptic analysis showed two main laryngeal behaviours in producing ornamentations: (1) 'lyrical' vibratos mobilising the entire laryngeal block; (2) 'Mongolian' trills with essentially supraglottic movements, the arytenoids being mobilised independently of the rest of the laryngeal block. Patients demonstrated similar aryepiglottic trilling to fulfil a function of voicing. The acoustic analysis showed that the fundamental frequency and the intensity were in phase for vibrato, contrary to the 'Mongolian' trills which were in opposite phase, underlying a change of laryngeal vibratory mechanisms.
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Affiliation(s)
- Lise Crevier-Buchman
- Phonetics and Phonology Laboratory, CNRS/Université Paris 3 Sorbonne-Nouvelle, Paris, France.
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Topaloğlu I, Bal M, Salturk Z. Supracricoid laryngectomy with cricohyoidopexy: oncological results. Eur Arch Otorhinolaryngol 2011; 269:1959-65. [PMID: 22130913 DOI: 10.1007/s00405-011-1844-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2011] [Accepted: 11/09/2011] [Indexed: 11/25/2022]
Abstract
This study assessed the oncological results in patients undergoing supracricoid laryngectomy with cricohyoidopexy. A cohort of 44 patients surgically treated using supracricoid laryngectomy with cricohyoidopexy between June 2001 and December 2009 was retrospectively analyzed. The mean follow-up period was 53.2 (±24.7) months. The Kaplan-Meier method was used to analyze overall survival and disease-specific survival, as well as survival according to T2 and T3 subgroups. Overall survival rates at 3 and 5 years were 90.5 and 84.1%, respectively. The 3- and 5-year disease-specific survival rates were 95.4 and 92.5%, respectively. Overall survival for patients with T2 disease was 87.5% at 3 years and 80.8% at 5 years. For T3, the corresponding rates were 91.8 and 87.0%. Disease-specific survival for patients with T2 disease was 93.3% at 3 years and the same at 5 years; the corresponding rates for T3 were 96.4 and 91.4%. The differences between T2 and T3 patients at 3 and 5 years with respect to overall and disease-specific survival were not statistically significant (P = 0.903 and P = 0.863, respectively). Recurrence was local in one patient (2.2%) and regional in three (6.8%). There were three distant metastases (6.8%) and one second primary carcinoma (2.2%). These findings support the use of supracricoid laryngectomy with cricohyoidopexy as an oncologically safe technique in properly selected patients with laryngeal carcinoma.
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Affiliation(s)
- Ilhan Topaloğlu
- 1st Ear Nose and Throat Clinic, İstanbul Okmeydanı Training and Research Hospital, İstanbul, Turkey.
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Zhang QQ, Zhang H, Liu ZL, Wang Q, Song XC, Zhang TZ, Sun Y, Jiang SH, Wang L. [Effect of hyoid suspension with uvulopalatopharyngoplasty in the treatment of obstructive sleep apnea hypopnea syndrome]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2011; 46:556-560. [PMID: 22088284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To discuss the methodology and therapeutic effect of hyoid suspension in association with uvulopalatopharyngoplasty (UPPP) in the treatment of severe obstructive sleep apnea hypopnea syndrome (OSAHS). METHODS Sixty-nine patients with severe OSAHS (apnea hyponea index, AHI > 30) were treated with hyoid suspension and UPPP. Sixty-one patients were followed for 6 months (48 of them for 12 months). Polysomnogram (PSG) tests were performed and an Epworth sleepiness scale (ESS) was recorded preoperatively and postoperatively in these patients. RESULTS After the surgery,the snoring of the patients disappeared or was alleviated to varing degrees. Eighteen patients underwent fiberoptic nasopharyngolaryngoscopic examination. Twelve of them showed palatopharyngeal and glossopharyngeal stenosis was improved 6 months after surgery. Six patients showed no change, but had no glossoptosis. Fourteen patients underwent fiberoptic nasopharyngolaryngoscopic examination 1 year after surgery, with no recurrence of the stenosis being found. A decrease of 50% in the AHI was considered effective, and in patients the effective rate was 78.7% (48/61) 6 months after the operation and 75.0% (36/48) 1 year after the operation. The average AHI decreased from 44.8 to 15.1 and 17.2, and the minimum arterial oxygen saturation average increased from 0.512 to 0.880 and 0.730. Matching t tests were utilized and the results of follow-up indicated that there was a significant improvement in the indexes in those cases which could be followed up (P < 0.01). The average of the ESS was 6.7 six months after operation and 7.2 one year after operation, with a significant decrease compared to the preoperative (16.6) data (P < 0.01). CONCLUSIONS Modified hyoid suspension in association with UPPP has the advantage of a simple operation, short hospitalization and less expense, and the effect of the operation was significant. Patients with palatopharyngeal and glossopharyngeal stenosis should be chosen for this operation.
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Affiliation(s)
- Qing-quan Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Yuhuangding Hospital, Yantai, China.
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Abstract
PURPOSE Dysphagia after head and neck cancer treatment is a health care issue; in some cases, the cause of death is not cancer but, rather, the passage of food or liquid into the lungs. Hyoid displacement is known to be important to safe swallowing function. The purpose of this study was to evaluate hyoid displacement after cancer treatment. METHOD Hyoid displacement was measured in healthy persons with normal swallowing function, head and neck cancer patients postradiation only, and head and neck cancer patients postsurgery only. Three bolus conditions (5 ml and 10 ml liquid and 5 ml paste) were examined. The influence of 2 different measurement algorithms on the extent of hyoid movement was also explored. RESULTS Radiation-therapy patients in this study had greater hyoid displacement than did surgery patients. Bolus viscosity and measurement method significantly influenced displacement results, whereas bolus volume did not. However, more multiple swallows occurred with 10 ml liquid; this may account for the apparent insignificance of bolus volume. CONCLUSIONS These findings can be used to assist head and neck cancer treatment planning and counseling. Because hyoid measurement methods influence research conclusions, this aspect of design should be considered when interpreting research findings.
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Affiliation(s)
- Yihe Zu
- University of Illinois at Urbana-Champaign, USA.
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Abstract
OBJECTIVE To review the outcomes of hyoid myotomy and suspension with a mandibular screw anchoring device. STUDY DESIGN Case series with chart review. SETTING Academic and private sleep surgery clinics. METHODS The study is a consecutive case series of patients undergoing hyoid myotomy and suspension using a mandibular screw suspension device as part of multilevel treatment of obstructive sleep apnea (OSA). Outcomes of interest included complication rates, change in daytime sleepiness scores, and change in apnea-hypopnea index (AHI). RESULTS Ten women and 23 men with a mean age of 54 years (range, 33-73 years) underwent hyoid myotomy and suspension using a mandibular screw suspension device. Four (12%) patients experienced minor complications, including neck seroma (3 patients) and tongue edema (1 patient). Epworth Sleepiness Scale scores fell from a preoperative median of 12 to a postoperative median of 6 (P = .002). Ten patients (30%) refused the postoperative sleep study. In the 23 patients who underwent postoperative sleep studies, AHI scores decreased from a preoperative mean ± SD of 40.9 ± 25.1 to 18.6 ± 21.2 postoperatively (P = .001). Ten patients (30%) achieved a postoperative AHI below 10. The Repose system was initially applied using a standard hyoid dissection but was later modified using a minimally invasive small incision (<2 cm) approach that demonstrated significantly fewer complications (P = .04). CONCLUSION Hyoid myotomy and suspension with a mandibular screw anchor is an effective method with which to address hypopharyngeal collapse in multilevel surgery for OSA. The procedure can be performed with a small-incision, minimally invasive approach with minimal complications and patient morbidity.
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Affiliation(s)
- M Boyd Gillespie
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.
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Affiliation(s)
- John Maddalozzo
- Department of Surgery, Division of Pediatric Otolaryngology, Children's Memorial Hospital, Chicago, Illinois 60614, USA.
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Abstract
Osteoblastoma is a rare bone tumor that usually affects the vertebrae. We present the first known case of osteoblastoma arising in the hyoid bone, in a patient who presented with a neck mass and dysphagia. The radiographic appearance of the tumor is similar to that of low-grade chondrosarcoma, with well-defined expansion of the bone and central chondroid matrix.
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Affiliation(s)
- C M Rivera-Serrano
- Department of Otolaryngology, University of Pittsburgh School of Medicine, 200 Lothrop Street, Pittsburgh, PA 15215, USA
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Lin RY, Chen JF, Guo ZQ, Peng JH, Zhou J, Fang WQ. [Comparing extended vertical partial laryngectomy and cricohyoidoepiglottopexy in the treatment of laryngeal carcinoma]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2010; 45:305-309. [PMID: 20627050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
OBJECTIVE To compare the results of extended vertical partial laryngectomy (similar to modified supracricoid partial laryngectomy with cricohyoidoepiglottopexy) and cricohyoidoepiglottopexy in the treatment of laryngeal carcinoma. METHODS Retrospectively analyzed on the results and prognosis in patients underwent extended vertical partial laryngectomy and cricohyoidoepiglottopexy between 1998 and 2005. The operation was similar to extended vertical partial laryngectomy. The healthy vocal cord and ventricular band as well as about 1/3 to 2/3 laminas of thyroid cartilage were removed. The healthy cricoarytenoid joint was reserved. The vocal cord, ventricular band, fixed or limitation of motion arytenoid cartilage and 2/3 laminas of thyroid cartilage in ill side were removed. The posteroinferior border of laminas of thyroid cartilage in both sides were reserved. The cricoid was lifted and fixed with hyoid epiglottis directly. Extended vertical partial laryngectomy group consisted of 37 patients with glottic carcinoma (stage T2 16 cases, stage T3 21 cases) and cricohyoidoepiglottopexy group consisted of 34 patients with glottic carcinoma (stage T2 12 cases, stage T3 21 cases, stage T4 1 case). RESULTS Kaplan-Meier analysis was performed to calculate the survival rates. The three-year cumulative survival rate was 91.7% in extended vertical partial laryngectomy group and 87.5% in cricohyoidoepiglottopexy group respectively. There was no significant difference between the two groups (P > 0.05). The five-year cumulative survival rate was 80.6% in extended vertical partial laryngectomy group and 81.3% in cricohyoidoepiglottopexy group respectively. There was also no significant difference between the two groups (P > 0.05). The decannulation rate was 100% (37/37) in extended vertical partial laryngectomy group and 94.1% (32/34) in cricohyoidoepiglottopexy group respectively. The decannulation time was (14.0 + or - 2.3) days in extended vertical partial laryngectomy group and (19.0 + or - 4.6) days in cricohyoidoepiglottopexy group respectively. The incidence of aspiration was 2.7% (1/37) in modified group and 23.5 (8/34) in cricohyoidoepiglottopexy group respectively evaluated at 8th weeks post-operatively. The evaluation of deglutition disorder was analyzed by Ridit analysis in both groups and the results showed that there was significant difference between the two groups (U = 7.341, P < 0.001). The symptom of aspiration in extended vertical partial laryngectomy group was significant less than in cricohyoidoepiglottopexy group. CONCLUSIONS Although the survival rate was not different between the two groups. The preservation of laryngeal function in extended vertical partial laryngectomy group was significant better than in cricohyoidoepiglottopexy group and extended vertical partial laryngectomy.
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Affiliation(s)
- Ren-yu Lin
- Department of Otorhinolaryngology, First Affiliated Hospital of Wenzhou Medical College, Wenzhou 325000, China
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Xu X, Li L, Liu HH. [Extended resection of central hyoid bone and connective tissue for the treatment of recurrent and infected thyroglossal duct cysts.]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2010; 45:160-161. [PMID: 20398519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Pease AP, van Biervliet J, Dykes NL, Divers TJ, Ducharme NG. Complication of partial stylohyoidectomy for treatment of temporohyoid osteoarthropathy and an alternative surgical technique in three cases. Equine Vet J 2010; 36:546-50. [PMID: 15460081 DOI: 10.2746/0425164044877413] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- A P Pease
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York 14853, USA
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Portas JG, Queija DDS, Arine LP, Ferreira AS, Dedivitis RA, Lehn CN, Barros APB. Voice and swallowing disorders: functional results and quality of life following supracricoid laryngectomy with cricohyoidoepiglottopexy. Ear Nose Throat J 2009; 88:E23-E30. [PMID: 19826987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
We conducted a prospective study of 11 patients with laryngeal cancer who underwent supracricoid laryngectomy with cricohyoidoepiglottopexy. Our goal was to evaluate their postoperative voice and swallowing function and to ascertain the impact that surgery had on patient-perceived quality of life. Postoperative assessments were made by auditory perception analyses, objective voice analyses, the Voice Handicap Index questionnaire, the Quality of Life in Swallowing Disorders questionnaire, and videofluoroscopy. Following surgery, 8 patients experienced severe dysphonia and 3 experienced moderate dysphonia. Also, 5 patients experienced mild to severe dysphagia whereas 6 patients experienced normal or near-normal swallowing function. Postoperative acoustic measurements were higher than expected, and spectrographic evaluation revealed the presence of high-grade noise without predominant concentration over the spectrum. Some association with the grade of dysphonia and self-perception of voice handicap was observed. With regard to swallowing, 5 patients (45.5%) showed a decrease in laryngeal remnant elevation and a slight or moderate degree of stasis in the oropharynx. Overall, patients reported good quality of life regarding both voice and swallowing. No relationship between the functional swallowing and the number of preserved arytenoid cartilages was observed.
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Affiliation(s)
- Juliana Godoy Portas
- Department of Voice, Speech, and Swallowing Rehabilitation, Hospital Heliópolis, São Paulo, Brazil
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Luo ZH, Chen JH, Tao ZZ. [Hyoid suspension treatment of obstructive sleep apnea hypopnea syndrome]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2009; 44:877-880. [PMID: 20079065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Chen SC, Shi S, Zheng HL, Chen DH, Zhu MH, Liu F, Tang HH, Wang K. [Combination of genioglossus advancement by non-trephine technic with uvulopalatopharyngoplasty for treatment of obstructive sleep apnea-hypopnea syndrome]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2009; 44:815-818. [PMID: 20079050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To evaluate the efficacy and reliability of genioglossus advancement and hyoid suspension with non-trephine technic (GAHM) and uvulopalatopharyngoplasty (UPPP) for surgical obstructive sleep apnea-hypopnea syndrome treatment. METHODS Twenty-six patients (4 female and 22 male) were classified as moderate and severe cases in terms of apnea hypopnea index (AHI) and Friedman classification in the present study. All cases patients underwent genioglossus advancement and hyoid suspension with non-trephine technic Uvulopalatopharyngoplasty UPPP. Pre- and postoperative polysomnography and Epworth sleepiness scale were performed to assess the therapeutic outcomes. RESULTS The whole operation time ranged from 120-180 minutes. The average amount of bleeding in genioglossus advancement was about 50-100 ml. There were no severe complications during and after the operation. All the cases were followed up to one year. After surgery, AHI was decreased in both group cases, (42.9 +/- 6.6 vs 16.2 +/- 5.7) in the severe group, and 21.3 +/- 4.4 vs 11.3 +/- 5.2 (x(-) +/- s) in the moderate group. With success defined as AHI decreased by more than 50 per cent after surgery, the total success rate in moderate and severe group was 83.3% and 91.7%, respectively (P < 0.01). Furthermore, the success rate of the moderate group was higher than those of the severe group (P < 0.01). CONCLUSION GAHM combined with UPPP may be beneficial for the moderate and severe OSAHS patients with oropharyngeal and hypopharyngeal obstruction.
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Affiliation(s)
- Shi-Cai Chen
- Department of Otorhinolaryngology Head and Neck Surgery, Changhai Hospitai, Second Military Medical University, Shanghai 200433, China
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Dib N, Benhammou A, Meziane M, Harmouch A, Nazih N, Essakali L, Kzadri M, Sefiani S. [Papillary adenocarcinoma on ectopic thyroid tissue]. ACTA ACUST UNITED AC 2009; 126:65-70. [PMID: 19296927 DOI: 10.1016/j.aorl.2009.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2009] [Accepted: 02/09/2009] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To report a case of papillary adenocarcinoma occurring on ectopic thyroid tissue in the hyoid bone region. MATERIAL AND METHODS A 57-year-old patient consulted for a cervical mass appearing 1 year before, with no signs of compression. The thyroid function was normal. RESULTS The examination showed a firm tumefaction, fixed on the hyoid bone, with undetermined limits, measuring approximately 8 cm. The thyroid gland was in the normal pretracheal position. The cervical tomodensitometry objectified an osteolytic process centered on the hyoid bone with a fleshy zone of tissue density and calcifications. Cervical MRI provided a more precise assessment of the extension of the mass and confirmed the integrity of the other structures, in particular the endo-larynx. The tumor was totally resected via a cervical approach. The pathologic study suggested a papillary adenocarcinoma on ectopic thyroid tissue. The treatment was completed by a total thyroidectomy with normal histological results. CONCLUSIONS Papillary adenocarcinoma on ectopic thyroid is a very rare situation. Its diagnosis is histological. Its treatment is primarily surgical, sometimes associated with radioiodine I-131 therapy.
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Affiliation(s)
- N Dib
- Service d'ORL et de chirurgie cervicofaciale, hôpital des spécialités, CHU de Rabat-Salé, Rabat, Maroc.
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Abstract
OBJECTIVES/HYPOTHESIS The aim of this study is to evaluate the results of primary hyoidthyroidpexia (HTP) and HTP after previous uvulopalatopharyngoplasty (UPPP) in patients with obstructive sleep apnea syndrome (OSAS). STUDY DESIGN Prospective case series. METHODS Thirty-one patients with obstruction at tongue base level and moderate to severe sleep apnea syndrome underwent HTP. Seventeen patients underwent surgery after an unsuccessful UPPP (secondary HTP), and in 14 patients, primary HTP was performed. RESULTS Patients who underwent primary HTP showed a significant decrease in apnea hypopnea index (AHI) (P = .007), whereas those patients who had secondary HTP did not (P = .06). Overall, the AHI significantly changed (P = .0005). Visual analogue scales for snoring and hypersomnolence and the Epworth sleepiness scores showed significant improvement for both groups, without any difference between them. HTP was considerably less painful when compared with UPPP. CONCLUSION This study demonstrates that HTP, in particular as primary treatment in cases of obstruction at tongue base level, is a valuable addition to the therapeutic armamentarium of moderate to severe OSAS. Selection criteria are moderate to severe OSAS with preferably a body mass index less than 27, multilevel obstruction with emphasis on the base of tongue, small tonsils, and normal uvula, without a floppy epiglottis or a palatal stenosis after UPPP.
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Affiliation(s)
- Cindy den Herder
- ENT Department, St. Lucas Andreas Hospital Amsterdam, Noord-Holland, The Netherlands
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Decotte A, Serrano E, Woisard V, Rose X, Percodani J, Pessey JJ, Vergez S. [Ruptured pexis after supracricoid partial laryngectomy: a series of 5 cases]. Rev Laryngol Otol Rhinol (Bord) 2009; 130:225-229. [PMID: 20597402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
OBJECTIVES Supracricoid partial laryngectomies have a rare but a specific complication which is the rupture of the pexy. After cricohyoidoepiglottopexy or cricohyoidopexy, a separation can appear between the hyoid bone and the cricoid cartilage. Our objective was to define how to treat and to prevent this complication. METHODS One hundred and one supracricoid partial laryngectomies were performed in our department between 1980 and 2006. A retrospective analysis of the medical charts and operative files revealed that 5 patients have had a ruptured pexy. A review of the diagnosis, management, and outcome of these five cases is presented and discussed in this paper. RESULTS The diagnosis was done in the first post-operative month for all cases. Delay in decannulation time, swallowing disorders, local infection were associated with the rupture of the pexy. The separation between the hyoid bone and the cricoid cartilage was also suspected at neck palpation and in endoscopy. Lateral plain Xrays of the neck or CT scans were used to confirm the diagnosis. A medical treatment, a completion total laryngectomy and three revisions of the pexis were performed. CONCLUSIONS In our series, an antecedent of radiation before surgery appears to be a risk factor for the development of this specific complication. A revision of the pexis procedure is advocated in case of a major ruptured pexis.
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Affiliation(s)
- A Decotte
- CHU Rangueil-Larrey, Service d'ORL et de Chirurgie Cervico-Faciale, 24 chemin de Pouvourville TSA 30030, 31059 Toulouse Cedex 9, France
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Li B, Li CH, Guo H, Chen J, Wang SX. [Analysis of 27 cases of defect restoration using infrahyoid myocutaneous flap after intraoral cancer surgery]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2008; 43:826-829. [PMID: 19267973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVE To compare different surgical techniques and clinical effectiveness using infrahyoid myocutaneous flap to restore effects after intraoral cancer surgery. METHODS It is a retrospective study in Sichuan cancer hospital, from May 1994 to March 2007, 27 cases were treated surgically with unilateral infrahyoid myocutaneous flap, 19 males and 8 females. Seven cases of squamous cell tongue carcinoma, 4 cases of tongue root carcinoma, 16 cases of mouth floor carcinoma. The biggest flap was 4 cm x 8 cm. In 8 cases, the flap was formed since the remote end reverse vascular traveling and carried with inferior 1/3 muscular tissue of the sternocleidomastoid muscle on the same side (retrograde flap forming), in 19 cases, vascular pedicle was anatomies with microscopic blood vessel-operating skills along vascular traveling before the flap forming (anterograde flap forming). Eleven cases of the reservation vascularized and infrahyoid muscles in the hyoid attachment (combination pedicle), in 16 cases, the arteria and vena thyroidea superior reserved as the pedicle accompanied with the vena jugularis anterior (the axial vessel pedicle); in 21 cases, the distal end of the vena jugularis interna was tied up at the place where the vena facialis communis joins to the vena jugularis interna. and the vena jugularis anterior was reserved within the flap (interference return). RESULTS The survival rate of total 27 cases are 77.8%. The flap necrosis in two cases of total group, 1/3 - 1/2 skin necrosis of the flap was found in 4 cases, in the six cases, flap was formed with retrograde flap forming carry with the ipsilateral sternocleidomastoid, the reason of necrosis was venous flow obstruction. Twenty-one flaps of interference return are all survived, the flap in 19 cases with anterograde flap forming all survived, and 16 cases of the axial infrahyoid flap all survived. Follow-up nine months to 13 years with a median follow-up time for four years. Lost four cases, 23 followed up cases did not found on the flap recurrence of cancer. The primary tumor recurrence in three cases, six cases of cervical lymph node recurrence, Kaplan-Meier method statistics 3, 5-year survival rates were 69.8%, 47.2%, respectively. CONCLUSIONS To improve the survival rate, the surgical approach of anterograde flap forming is suitable, to anatomies the axial vessel pedicle with microscopic skills, in particular should pay attention to ensure that venous return. Carrying with the same side of the sternocleidomastoid muscle tissue and retaining hyoid attachment of infrahyoid muscles will not increase the survival rate of the muscle flap.
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Affiliation(s)
- Bin Li
- Department of Head and Neck Surgery, Tumour Hospital of Sichuan, Chengdu, China.
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Kasapoğlu F, Erişen L, Erdoğan C. Suspicion of cricohyoidopexy line rupture after supracricoid partial laryngectomy and the value of computed tomography to exclude this complication. Kulak Burun Bogaz Ihtis Derg 2008; 18:179-181. [PMID: 18985001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
We presented a 48-year-old man who underwent supracricoid partial laryngectomy with cricohyoidoepiglottopexy. He developed diffuse subcutaneous emphysema and saliva aspiration on the first postoperative day, arousing suspicion of a pexy line rupture. Palpation of the cricohyoid suture line and a lateral cervical X-ray were not helpful. Laryngeal computed tomography (CT) obtained demonstrated an undisturbed cricohyoidoepiglottopexy suture line. Some of the neck sutures were removed, a drain was placed under the neck flap, a tight dressing was applied, and surgical exploration was not necessary. Subcutaneous emphysema regressed in the following days and no other problem was seen. Subcutaneous emphysema was attributed to the air escape from the cricohyoid approximation line. Following supracricoid partial laryngectomy, rupture of the cricohyoidopexy line is a rare but serious complication that needs urgent exploration. Therefore, when there is suspicion, laryngeal CT is very important to rule out this condition. Moreover, a close cooperation is necessary with the radiologist who may not be familiar with disturbed anatomy by previous surgery.
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Affiliation(s)
- Fikret Kasapoğlu
- Department of Otolaryngology, Medicine Faculty of Uludağ University, Bursa, Turkey.
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Nakayama M, Okamoto M, Miyamoto S, Takeda M, Yokobori S, Masaki T, Seino Y. Supracricoid laryngectomy with cricohyoidoepiglotto-pexy or cricohyoido-pexy: Experience on 32 patients. Auris Nasus Larynx 2008; 35:77-82. [PMID: 17869042 DOI: 10.1016/j.anl.2007.04.018] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2006] [Revised: 03/14/2007] [Accepted: 04/06/2007] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Supracricoid laryngectomy (SCL) with Cricohyoidoepiglotto-pexy (CHEP) or Cricohyoido-pexy (CHP) is an organ preservation surgery indicated for early and selected advanced laryngeal cancers. To verify the clinical usefulness of supracricoid laryngectomy versus total laryngectomy, a retrospective review was conducted. METHODS We summarized the clinical and postoperative data of 32 patients who received SCL over the past 9 years (1997-2005). Five-year survival rate of the SCL patient group (29 cases) was compared with that of the patient group receiving total laryngectomy (35 cases) within the same period. RESULTS Wound infection was detected in 12 patients (38%). Those with severe infection, which required surgical intervention, included two cases of ruptured pexis and two cases showing cricoid cartilage necrosis induced by Forestier disease. There were two T4 cases that resulted in extensive excision. In one case, excision involved the posterior part of the cricoid cartilage resulting in insufficient closure of the neoglottis; the patient received total laryngectomy 30 months after SCL-CHEP because of persistent aspiration of liquid diet. In the other T4 case, the tumor invaded the thyroid and arytenoid cartilages but not the cricoid cartilage. Reposition of the remaining corniculate cartilage resulted in sufficient closure of the neoglottis; this patient subsequently acquired satisfactory laryngeal function. The 5-year overall survival rate was 86% for SCL group and 61% for the total laryngectomy group (limited to Stages III and IV glottic cancers). The causes of the four deaths were distant metastasis, neck metastasis, and intercurrent disease, respectively. Two patients are alive with distant disease. CONCLUSION Through our experience in this series, the functional and oncological results of SCL showed certain advantages over those of total laryngectomy. Particularly, the clinical impact of SCL-CHEP was impressive; this technique needs is recommended to both head and neck surgeons and patients.
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Affiliation(s)
- Meijin Nakayama
- Department of Otorhinolaryngology, Kitasato University School of Medicine, 1-15-1 Kitasato, Sagamihara, Kanagawa 228-8555, Japan
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Breda E, Fernandes J, Monteiro E. [Transhyoid bucopharyngectomy: a new surgical approach to oropharyngeal tumours]. Rev Laryngol Otol Rhinol (Bord) 2008; 129:197-200. [PMID: 19694163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVES To present a new surgical technique for oropharyngeal tumours. We describe the technique together with the indications, limits and pitfalls. SURGICAL TECHNIQUE Transverse cervical collar incision. Bilateral neck dissection according to patient's nodal status. Infrahyoide muscles dissection from the posterior-inferior surface of the hyoid bone body. Division of this structure bilateraly at it junction with greater corns. Push back and up of the hyoid bone together with its suprahyoid muscles upon the mandible. Incision of the mouth floor Push down of the tongue to the cervical region. Tumour bloc resection with optimal exposure. Wound closure with or without reconstruction according to the size of surgical defect. Reposition of the hyoid bone and suprahyoid muscles in place, and suture of infrahyiod muscles to hyoid bone. Neck closure. Transitory tracheotomy. MAIN INDICATIONS: T2-3 of tongue base and vallecula, T2-3 of tonsil. DISCUSSION Surgical therapy, alone or integrated in a multimodality program, maintains an essential role in the management of patients with oropharyngeal tumours. In locally advanced tumours transmandibular approach is the method usually employed. Despite the wide surgical exposure, this approach may cause significant morbidity secondary to mandibular interruption. To avoid this, mandible-sparing procedures as suprahyoid, transhyoid and transpharyngeal approaches are advocated, but usually need complex manoeuvres and don't allow a large field for resection. These problems can be solved with the described technique we called transhyoid bucopharyngectomy. CONCLUSION Transhyoid bucopharyngectomy is an easy and safe procedure for head and neck surgeons, offers an acceptable level of postoperative swallowing and speech function, without the morbidity associated with transmandibular approaches, besides providing a good and wide exposure of the tumour to be removed. Bone invasion is the most important limit for this technique.
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Affiliation(s)
- E Breda
- Portuguese Institute of Oncology of Porto, Department of Otorhinolaryngology and Head and Neck Surgery, Porto, Portugal.
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Abstract
Chondromas of the larynx are rare neoplasms; only a few examples of cartilaginous tumors affecting hyoid bone have been reported. A 33-year-old woman presented with a neck mass on the left carotid triangle. The patient's computed tomography and magnetic resonance imaging revealed a heterogenous mass, which seemed to originate from the left greater cornu of hyoid. The mass was excised using a transcervical approach with left greater cornu of hyoid bone. The pathologic diagnosis was chondroma of hyoid. Expert radiologic and pathologic review is mandatory in cartilaginous neoplasms of the larynx. Cartilaginous neoplasms of the hyoid should be included in the differential diagnosis of neck masses at the carotid triangle.
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Affiliation(s)
- Ibrahim Ozcan
- Ankara Numune Education and Research Hospital 4th ENT Clinic, Ankara, Turkey.
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Sheng J, Luo Z, Kong Y, Jiang Y. [Hyoid suspension with repose system combined with UPPP in severe OSAHS patients: short-term results]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2007; 21:1127-1128. [PMID: 18330261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE To explore the effect of a comprehensive surgical approach of hyoid suspension with Repose system plus uvulopalatopharyngoplasty (UPPP) on the treatment of severe obstructive sleep apnea hypopnea syndrome (OSAHS). METHOD Twelve patients with severe OSAHS (AHI > 40) diagnosed by polysomnography, were determined for the obstruction in both the velo-pharyngeal and the hypopharynx by preoperative physical examination, fiberoptic pharyngo-laryngoscopy. Two cases were given continuous airway pressure via nose, seven days before operation and then were performed hyoid suspension plus UPPP. The follow up was 3 months postoperatively. The pair T test was used to compare the preoperative and postoperative results by SPSS11.0 for windows. RESULT At postoperative 3 month, there were statistically significance between preoperative and postoperative measurement in all. Mean AHI decreased from preoperative 69.28 +/- 6.50 to postoperative 19.77 +/- 9.23, lowest mean oxygen saturation increased from 65.25 -/+ 3.14 to 90.17 +/- 2.86. Snoring and sleep apnea disappeared or lessened, with the disappearance or decrease of lethargy at daytime. No severe complication occurred. CONCLUSION Comprehensive surgical approach of hyoid suspension with Repose system plus UPPP is effective surgical approach for patients with severe OSAHS who suffered from oropharyngeal and hypopharyngeal obstruction in short- term result.
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Affiliation(s)
- Jianfei Sheng
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, 430060, China
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Abstract
Obstructive sleep apnea (OSA) is the result of upper airway obstruction during sleep. Hypopharyngeal airway obstruction can be caused by the prominence or relaxation of the base of the tongue, lateral pharyngeal wall, and occasionally, the aryepiglottic folds or epiglottis. Although nasal continuous positive airway pressure (CPAP) is considered as the first treatment for obstructive sleep apnea, surgery has been shown to be a viable option for patients who are intolerant of positive pressure therapy. This article presents the current state of hypopharyngeal surgery for sleep apnea. Preoperative airway evaluation with fiberoptic nasopharyngoscopy, the use of lateral cephalometric radiograph, and the formulation of a surgical plan with selection of procedures to address hypopharyngeal obstruction are discussed.
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Affiliation(s)
- Kasey K Li
- Stanford Sleep Disorders Clinic and Research Center, 401 Quarry Road, Stanford, CA 94305, USA.
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Dattilo DJ, Aynechi M. Modification of the Anterior Mandibular Osteotomy for Genioglossus Advancement With Hyoid Suspension for Obstructive Sleep Apnea. J Oral Maxillofac Surg 2007; 65:1876-9. [PMID: 17719419 DOI: 10.1016/j.joms.2006.10.052] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2006] [Revised: 10/17/2006] [Accepted: 10/24/2006] [Indexed: 10/22/2022]
Affiliation(s)
- David J Dattilo
- Division of Oral & Maxillofacial Surgery, Allegheny General Hospital, Pittsburgh, PA, USA.
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Affiliation(s)
- N Ray Lee
- Department of Oral and Maxillofacial Surgery, Medical College of Virginia, Commonwealth University, Richmond, VA, USA.
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