Greater Cornu Of Hyoid Bone Research Articles

Radiological and cadaveric study of anatomical safe zone for transoral base of tongue surgery.

The aim of this study is to identify a surgical safe zone in base of tongue surgery. Fifteen Fresh frozen cadavers (30 head and neck regions) were included in the anatomical study. Twenty-two CT-angiogram (CTA) scans of neck were included in the radiological study. Surgical safe zone for base of tongue surgery was studied in cadavers and correlated the same in CTA. Depth of the lingual artery (LA) from the tongue surface and distance of origin of lingual artery from tip of greater cornu of hyoid bone was significantly different when comparing anatomical to radiological study (p < 0.005). On protruded position of tongue, lingual artery appeared more close to the tongue surface and was never encountered posterior to foramen caecum. Preoperative CTA evaluation would over-estimate the depth of LA putting the lingual artery at risk during resection. A surgical safe zone exists posterior to foramen caecum and towards the midline.

External Laryngocoele or Anterior Jugular Vein Aneurysm (A Rare Clinical Entity): A Paradox Solved by A Few Simple Non-Invasive Radiological Tests

Introduction&#x0D; &#x0D; &#x0D; The differential diagnosis of a cystic upper neck mass that becomes prominent on coughing, straining, breath holding, or Valsalva manoeuvre includes mediastinal tumours and cysts, external laryngeal diverticula, and jugular venous aneurysms. Jugular venous aneurysms, while extremely rare, must be considered. We report the fifth case of anterior jugular aneurysm in an adult patient.&#x0D; &#x0D; Case Report&#x0D; &#x0D; A 55 year old female patient presented with a swelling in the upper part of right side of neck near the greater cornu of hyoid bone. The swelling increased with Valsalva, straining and while stooping forward. Clinically it was thought to be an external laryngocoele. However Colour Doppler Ultra-sonography and C.T angiogram of neck established it as of anterior jugular venous aneurysm by distinguishing from external laryngocoele.&#x0D; &#x0D; Discussion&#x0D; &#x0D; Patient presenting with unilateral cystic swelling in upper neck at upper border of thyroid cartilage which clinically bears the common provisional diagnosis of external laryngocele must be differentiated radiologically from anterior jugular venous aneurysm, (though rare in occurrence) to avoid a catastrophic incident during surgery.

Surgical anatomy of hypoglossal nerve as a guide for important head and neck surgeries

IntroductionThe hypoglossal nerve (HN) may be damaged during neck surgeries. A detailed understanding of the anatomy of the hypoglossal nerve in relation to various anatomical landmarks and surrounding structures is important to reduce procedural complications and the risk of nerve damage. MethodsThe study was carried out using 21 sagittal sections of head and neck of male cadavers (16 right and 5 left). To measure the required parameters the anatomical landmarks taken were the posterior belly of digastric muscle (PBD), descendens hypoglossi of ansa cervicalis (AC), bifurcation of common carotid artery (CCA), tip of the mastoid process (TMP), lingual artery (LA) at the posterior border of hyoglossus muscle, tip of greater cornu of hyoid bone (GH), bifurcation of CCA to the attachment of descendens hypoglossi (CCA-AC). ResultsThe length of PBD was 3.77±1.08cm on right side and 3.15±0.05cm on left side. The extended length was measured from the TMP to GH which was 6.7±1.23cm on right side and 6.75±0.75 on left side. The distance between HN to the GH did not vary much between right and left sides which were 1.21±0.35 and 1.2±0.69cm respectively. The distance between HN and LA at the posterior border of hyoglossus was 1.12±0.3cm on right side and 0.5±0.3cm on left side. DiscussionHN dissection is more complicated, as the location of the HN is much deeper. Moreover, there are no bony landmarks around the HN. Therefore PBD, CCA, ICA, ECA, LA were used as landmarks for HN in head and neck surgeries.

Transoral Surgical Anatomy and Clinical Considerations of Lateral Oropharyngeal Wall and Base of Tongue

Objectives: (1) Describe key anatomic structures in lateral oropharyngeal wall and tongue base transorally. (2) Determine surgical landmarks to increase intraoperative safety in transoral robotic surgery. Methods: Transoral dissections were performed endoscopically in 5 vascular silicone-injected fresh human cadavers. Anatomic structures were also confirmed with lateral neck dissections. Results: Tonsillar bed is largely made by superior pharyngeal constrictor muscle and overlying pharyngobasilar fascia. Palatoglossus and palatopharyngeus muscles limit this tonsillar bed anteriorly and posteriorly, forming tonsillar pillars. Stylopharyngeus and styloglossus muscles and stylohyoid ligament run between superior and middle pharyngeal constrictor muscles contributing to inferior tonsillar fossa. These structures are located just medial to facial, lingual, and internal maxillary arteries in parapharyngeal space. Internal carotid artery lies posterolateral to the branches of external carotid artery. Lingual artery injury might occur during base of tongue or inferior tonsil resections. At its origin, the lingual artery is situated deep to middle pharyngeal constructor muscle between stylohyoid ligament and greater cornu of hyoid bone posteriorly. At the tonsil-tongue base junction, it courses lateral and deep to styloglossus muscle. Keeping the resection over styloglossus muscle and stylohyoid ligament will prevent lingual artery injury. The glossopharyngeal nerve is positioned between stylohyoid ligament and styloglosus muscle. Its branches travel posteroinferiorly in inferior tonsillar fossa toward the base of tongue. Lingual nerve is vulnerable to injury as it emerges anterior to medial pterygoid muscle. Conclusions: A thorough understanding of transoral anatomy is critical for surgeons to perform transoral robotic surgery safely and efficiently.

Synostosis of the joint between the body and greater cornu of the human hyoid bone

The structure of the joint between the body and the greater cornu in the human hyoid bone was examined histologically in 259 cadavers (16-98 years). Joints were classified into three grades based on histological observations. Grade I showed fibrocartilage without degenerative change in the marginal region of the joint. Grade II showed prominent calcification or ossification on the outer margin of the joint without fusion. Grade III showed bony fusion. Histological changes with age were revealed by a comparison of the prevalences of these three grades among individuals of three age groups: young adult (16-39 years), middle aged (40-69 years), and elderly (70+ years). The frequency of hyoid bones with diarthrodial structure of this joint was compared between the age groups. The mean age of subjects with each grade of histological changes was calculated. Results show that, with age, the proportion of Grade I decreased significantly (P < 0.05) and that of Grade III increased significantly. Joints with diarthrodial structure decreased significantly with age relative to all subjects (P < 0.05). Clefts with necrotic tissue were observed in cartilage along with progressive calcification. The mean age of subjects with the histological changes was significantly higher than that of individuals without such changes (P < 0.05). Calcification and ossification of joints were induced with age from fibrous tissue and cartilage on the outer margin of a joint. The authors suggest that the age changes in the joint between the body and greater cornu of the hyoid bone may affect the mobility of this joint and may be related to masticatory and swallowing functions.

Parapharyngeal Space Tumors

ABSTRACTParapharyngeal space is a potential space in the neck extending from skull base to the greater cornu of hyoid bone. It is divided in prestyloid and poststyloid compartment by the fascia joining styloid process to tensor veli palatini. Tumors of parapharyngeal space are uncommon, comprising of less than 1% of all head and neck neoplasms. CT Scanning and MRI investigations is complimentary and both studies should be performed for evaluation of lesions in this area. Complete surgical excision is the mainstay of treatment.

Hyoid Chondroma Presenting as an External Neck Mass

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.

全身の骨病変を伴った過長茎状突起症例

We report a 44-year-old man with elongated styloid process and greater cornu of hyoid bone. The chief complaint was right neck pain on turning his head and the symptom had continued for one year. CT scan was useful for the diagnosis of both lesions. Surgical shortening of elongated styloid process and greater cornu of the hyoid bone was performed using the transcervical approach, and his symptom disappeared. The transcervical approach had the advantage of wide visualization and we could perform the surgical therapy safely.The case involved hypertrophy of the tibial tuberosity and block vertebra (Th7-8). These findings suggest that the elongated styloid process and hyoid bone were part of systematic ossifying changes of the osteo-chondro tissue.