BACKGROUND Metastasis to the hyoid bone is an exceptionally rare occurrence,with documented cases limited to breast,liver,colon,skin,lung,and prostate cancers.This report highlights an unusual case involving the metas...BACKGROUND Metastasis to the hyoid bone is an exceptionally rare occurrence,with documented cases limited to breast,liver,colon,skin,lung,and prostate cancers.This report highlights an unusual case involving the metastasis of lung adenocarcinoma to the hyoid bone,accompanied by a distinctive headache.Previous documentation involved surgical resection of the hyoid mass.We present a case displaying the benefits of palliative radiotherapy.CASE SUMMARY A 72-year-old non-smoking,non-alcoholic woman,initially under investigation for a year-long elevation in absolute lymphocyte count,presented with a monthlong history of intermittent throat pain.Despite negative findings in gastroenterological and otolaryngologic examinations,a contrast-enhanced chest computed tomography scan revealed a mediastinal mass and questionable soft tissue thickening in her left anterolateral neck.Subsequent imaging and biopsies confirmed the presence of lung adenocarcinoma metastasis to the hyoid bone.The patient was treated with platinum-based chemo-immunotherapy along with pembrolizumab.Ultimately,the lung cancer was unresponsive.Our patient opted for palliative radiation therapy instead of surgical resection to address her throat pain.As a result,her throat pain was alleviated,and it also incidentally resolved her chronic headaches.This is the second documented case of lung adenocarcinoma metastasizing to the hyoid bone.CONCLUSION Palliative radiotherapy may add to the quality of life in symptomatic patients with cancer metastatic to the hyoid bone.展开更多
Objective: Laryngeal reconstruction is needed to preserve laryngeal function in patients who have undergone extensive vertical or frontal partial laryngectomy. However, the procedure remains a difficult challenge. Sev...Objective: Laryngeal reconstruction is needed to preserve laryngeal function in patients who have undergone extensive vertical or frontal partial laryngectomy. However, the procedure remains a difficult challenge. Several reconstruction techniques have been described, but these techniques pose risks of complications such as laryngeal stenosis. This study aimed to evaluate the postoperative course and functional outcomes of a new technique that combined a muscle-pedicle hyoid bone and a thyrohyoid flap during laryngeal reconstruction after tumor resection. Methods: Four patients underwent extensive vertical partial or frontal partial laryngectomy for cancer. After tumor resection, laryngeal reconstruction was performed using the proposed technique. Postoperative recovery time, complications, and oncologic results were evaluated. Results: The four patients were successfully treated with the proposed technique. No dyspnea, dysphagia, or death occurred during the postoperative course. Decannulation was performed after a median of 3 days. The average postoperative hospital stay was 7 days. Short-term postoperative functional recovery was normal. No laryngeal stenosis or tumor recurrence was observed in any of the four patients after a follow-up period of more than 24 months. Conclusion: The combination of the muscle-pedicle hyoid bone and the thyrohyoid flap is a reliable procedure for laryngeal reconstruction after extensive vertical partial or frontal partial laryngectomy.展开更多
BACKGROUND Solitary plasmacytoma and unicentric Castleman disease(UCD)are rare lymphoproliferative disorders characterized by monoclonal plasma cells and a single set of locally enlarged lymph nodes,respectively.CASE ...BACKGROUND Solitary plasmacytoma and unicentric Castleman disease(UCD)are rare lymphoproliferative disorders characterized by monoclonal plasma cells and a single set of locally enlarged lymph nodes,respectively.CASE SUMMARY A 48-year-old Han Chinese man presented to our department with a neck mass and progressive foreign body sensation in his throat.18F-FDG positron emission tomography revealed focally increased radioactivity centered around the hyoid,and computed tomography(CT)revealed osteolytic lesions.Histopathology revealed Castleman-like features and CD138/CD38-positive mature plasma cells.Systemic work-up ruled out the possibility of POEMS syndrome,lymphoma,and multiple myeloma,leading to a final diagnosis of solitary hyoid plasmacytoma with UCD.The patient underwent partial hyoid resection and selective neck dissection,followed by intensity-modulated radiotherapy.99mTc-MDP singlephoton emission computed tomography/CT reevaluation showed neither local recurrence nor distant bone metastasis at the 40-mo follow-up.CONCLUSION The diagnostic process and differential diagnosis of this rare case provided valuable educational information to clinicians.展开更多
<b><span style="font-family:Verdana;">Objectives: </span></b></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><spa...<b><span style="font-family:Verdana;">Objectives: </span></b></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">T</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">he </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">objective</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> is to</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> determine whether there are differences in the position of the hyoid bone at rest in natural head position in subjects with mandibular hyperdivergence</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> and </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">to evaluate whether there are differences in hyoid position and antegonial notch depth in mandibular hyperdivergent males and females. </span><b><span style="font-family:Verdana;">Methods and Materials: </span></b><span style="font-family:Verdana;">This is a retrospective cohort study involving a review of lateral cephalometric radiographs of 45 adult men and women with mandibular hyperdivergency. Hyperdivergency was determined by cephalometric ranges of: SN-GoGn as least +2 SD from normal, Y-axis, PP-GoGN, and gonial angle greater than +1SD from normal. A group of 45 normodivergent adults served as a control, with cephalometric ranges of: SN-GoGn within </span></span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">±</span><span><span style="font-family:Verdana;">1 SD of normal, with only one measurement of the other three between +1 and +1.5 standard deviations. A custom digital cephalometric analysis, the Hyoid Analysis, was designed, to measure the vertical and horizontal position and inclination of the hyoid and the antegonial notch depth. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> In hyperdivergent subjects, the posterior aspect of the hyoid is located lower and more posterior, compared to the control group, while there is no difference in position of the anterior surface of the hyoid and the antegonial notch is 0.6</span></span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">mm deeper. In males, the posterior aspect of hyoid is lower by 8.5</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">mm, while the anterior surface is located 9.0</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">mm lower. In males, the hyoid is inclined more steeply than in females by 4.4 degrees and the antegonial notch is deeper than in females by 0.6</span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">mm. </span><b><span style="font-family:Verdana;">Conclusions: </span></b><span style="font-family:Verdana;">There are differences in hyoid bone position and mandibular morphology in hyperdivergent subjects compared to normodivergent subjects and in males compared to females.展开更多
BACKGROUND A swallowing disorder may occur following a brainstem stroke,especially one that occurs in the swallowing centers.Lateral medullary syndrome(referred to as LMS),a rare condition in which a vascular event oc...BACKGROUND A swallowing disorder may occur following a brainstem stroke,especially one that occurs in the swallowing centers.Lateral medullary syndrome(referred to as LMS),a rare condition in which a vascular event occurs in the territory of the posterior inferior cerebellar artery or the vertebral artery,has been reported to lead to more severe and longer lasting dysphagia.CASE SUMMARY We report two patients with dysphagia due to LMS and propose a novel technique named hyoid-complex elevation and stimulation technique(known as HEST).The two patients had no other functional incapacity back into life,but nasogastric feeding was the only possible way for nutrition because of severe aspirations.Swallowing function was evaluated by functional oral intake scale,modified water swallow test,surface electromyographic signal associated with video fluorography swallowing study to assess the situation of aspiration,pharyngeal residue,pharyngeal peristalsis,upper esophageal opening and the ability of deglutition.Both patients were treated with the HEST method for dysphagia and recovered quickly.CONCLUSION HEST is effective for shortening the in-hospital time and improving the quality of life for patients with dysphagia who suffer from LMS and likely other strokes.展开更多
Objective:Determine the effects of hyoid myotomy and suspension (HMS) without concurrent palatal or tongue base sleep surgery for obstructive sleep apnea (OSA).Method:Patients with OSA treated with HMS were identified...Objective:Determine the effects of hyoid myotomy and suspension (HMS) without concurrent palatal or tongue base sleep surgery for obstructive sleep apnea (OSA).Method:Patients with OSA treated with HMS were identified using CPT code (21685) at an academic and private sleep surgery clinic.Those who underwent concurrent palatal or tongue base sleep surgery were excluded.Outcomes included simultaneous procedures,apnea-hypopnea index (AHI),lowest oxyhemoglobin saturation (LSAT),and Epworth Sleepiness Scale (ESS).Results:Nineteen patients with OSA underwent HMS without palatal or tongue base sleep surgery.The average age at surgery was (55.3 ± 13.5) years with a majority of patients being male (71％).Concurrent procedures included the following:torus mandibularis excision (n =1),endoscopic sinus surgery (n =4),septoplasty (n =10),inferior turbinate reduction (n =12),and nasal valve repair (n =2).AHI improved signiflcantly from (39.7 ± 21.2) eventslh to (22.6 ± 22.7) events/h after HMS (P ＜ 0.01),which represented a 43％ reduction.LSAT significantly increased from (82.2％ ± 9.9％) to (86.6％ ± 6.2％),P ＜ 0.01.There was no improvement in ESS after surgery (8.2 ± 4.4) to (8.3 ± 5.2),P =0.904.A subset of patients with severe OSA (AHI ＞ 30 events/h) had an improvement in AHI from (49.9 ± 16.6) events/h to (29.1 ± 24.9) events/h,P ＜ 0.01.Conclusion:HMS without palatal or tongue base sleep surgery improves OSA severity.It can be considered as a valid option in the treatment of OSA in appropriately-selected patients.展开更多
Objective:To observe the effects and safety of Tongyan Spray(通咽喷雾剂)on the range and time of hyoid motion in patients with ischemic post-stroke dysphagia.Methods:Seventy-two patients with ischemic post-stroke dysp...Objective:To observe the effects and safety of Tongyan Spray(通咽喷雾剂)on the range and time of hyoid motion in patients with ischemic post-stroke dysphagia.Methods:Seventy-two patients with ischemic post-stroke dysphagia were selected and randomly assigned to a treatment group(36 cases)and a control group(36 cases)by a random number table from January 2013 to October 2014.All patients swallowed 4 kinds of barium meals with different traits respectively,and each patient underwent video fluoroscopy(VF)examination twice.In the treatment group,Tongyan Spray was sprayed to the pharynx on both sides and the middle part once respectively.The spray was applied 30 min before the second examination.Purified water at room temperature was used as placebo in the control group.The changes in the range and time of hyoid motion in both groups were observed before and after treatment.Results:Six patients dropped out in each group,and 60 patients completed the study and were included in the final analysis.Significant improvement was observed in the range of superior hyoid excursion distance and the time of hyoid motion in the treatment group compared with the control group(P<0.05).There were no obvious adverse reactions observed in oral mucosa in both groups during the whole study.Conclusion:Tongyan Spray was an effective and safe medicine for improving swallowing function in patients with ischemic post-stroke dysphagia.展开更多
文摘BACKGROUND Metastasis to the hyoid bone is an exceptionally rare occurrence,with documented cases limited to breast,liver,colon,skin,lung,and prostate cancers.This report highlights an unusual case involving the metastasis of lung adenocarcinoma to the hyoid bone,accompanied by a distinctive headache.Previous documentation involved surgical resection of the hyoid mass.We present a case displaying the benefits of palliative radiotherapy.CASE SUMMARY A 72-year-old non-smoking,non-alcoholic woman,initially under investigation for a year-long elevation in absolute lymphocyte count,presented with a monthlong history of intermittent throat pain.Despite negative findings in gastroenterological and otolaryngologic examinations,a contrast-enhanced chest computed tomography scan revealed a mediastinal mass and questionable soft tissue thickening in her left anterolateral neck.Subsequent imaging and biopsies confirmed the presence of lung adenocarcinoma metastasis to the hyoid bone.The patient was treated with platinum-based chemo-immunotherapy along with pembrolizumab.Ultimately,the lung cancer was unresponsive.Our patient opted for palliative radiation therapy instead of surgical resection to address her throat pain.As a result,her throat pain was alleviated,and it also incidentally resolved her chronic headaches.This is the second documented case of lung adenocarcinoma metastasizing to the hyoid bone.CONCLUSION Palliative radiotherapy may add to the quality of life in symptomatic patients with cancer metastatic to the hyoid bone.
基金supported by the Natural Science Foundation of Guangdong Province, China (Grant No. 303041353002)
文摘Objective: Laryngeal reconstruction is needed to preserve laryngeal function in patients who have undergone extensive vertical or frontal partial laryngectomy. However, the procedure remains a difficult challenge. Several reconstruction techniques have been described, but these techniques pose risks of complications such as laryngeal stenosis. This study aimed to evaluate the postoperative course and functional outcomes of a new technique that combined a muscle-pedicle hyoid bone and a thyrohyoid flap during laryngeal reconstruction after tumor resection. Methods: Four patients underwent extensive vertical partial or frontal partial laryngectomy for cancer. After tumor resection, laryngeal reconstruction was performed using the proposed technique. Postoperative recovery time, complications, and oncologic results were evaluated. Results: The four patients were successfully treated with the proposed technique. No dyspnea, dysphagia, or death occurred during the postoperative course. Decannulation was performed after a median of 3 days. The average postoperative hospital stay was 7 days. Short-term postoperative functional recovery was normal. No laryngeal stenosis or tumor recurrence was observed in any of the four patients after a follow-up period of more than 24 months. Conclusion: The combination of the muscle-pedicle hyoid bone and the thyrohyoid flap is a reliable procedure for laryngeal reconstruction after extensive vertical partial or frontal partial laryngectomy.
基金Supported by Key Program of the Medical Engineering Cross Research Fund of Shanghai Jiao Tong University,No.YG2019QNA55Tou-Yan Innovation Team Program of Heilongjiang Province,No.2019-15。
文摘BACKGROUND Solitary plasmacytoma and unicentric Castleman disease(UCD)are rare lymphoproliferative disorders characterized by monoclonal plasma cells and a single set of locally enlarged lymph nodes,respectively.CASE SUMMARY A 48-year-old Han Chinese man presented to our department with a neck mass and progressive foreign body sensation in his throat.18F-FDG positron emission tomography revealed focally increased radioactivity centered around the hyoid,and computed tomography(CT)revealed osteolytic lesions.Histopathology revealed Castleman-like features and CD138/CD38-positive mature plasma cells.Systemic work-up ruled out the possibility of POEMS syndrome,lymphoma,and multiple myeloma,leading to a final diagnosis of solitary hyoid plasmacytoma with UCD.The patient underwent partial hyoid resection and selective neck dissection,followed by intensity-modulated radiotherapy.99mTc-MDP singlephoton emission computed tomography/CT reevaluation showed neither local recurrence nor distant bone metastasis at the 40-mo follow-up.CONCLUSION The diagnostic process and differential diagnosis of this rare case provided valuable educational information to clinicians.
文摘<b><span style="font-family:Verdana;">Objectives: </span></b></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">T</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">he </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">objective</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> is to</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> determine whether there are differences in the position of the hyoid bone at rest in natural head position in subjects with mandibular hyperdivergence</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> and </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">to evaluate whether there are differences in hyoid position and antegonial notch depth in mandibular hyperdivergent males and females. </span><b><span style="font-family:Verdana;">Methods and Materials: </span></b><span style="font-family:Verdana;">This is a retrospective cohort study involving a review of lateral cephalometric radiographs of 45 adult men and women with mandibular hyperdivergency. Hyperdivergency was determined by cephalometric ranges of: SN-GoGn as least +2 SD from normal, Y-axis, PP-GoGN, and gonial angle greater than +1SD from normal. A group of 45 normodivergent adults served as a control, with cephalometric ranges of: SN-GoGn within </span></span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">±</span><span><span style="font-family:Verdana;">1 SD of normal, with only one measurement of the other three between +1 and +1.5 standard deviations. A custom digital cephalometric analysis, the Hyoid Analysis, was designed, to measure the vertical and horizontal position and inclination of the hyoid and the antegonial notch depth. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> In hyperdivergent subjects, the posterior aspect of the hyoid is located lower and more posterior, compared to the control group, while there is no difference in position of the anterior surface of the hyoid and the antegonial notch is 0.6</span></span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">mm deeper. In males, the posterior aspect of hyoid is lower by 8.5</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">mm, while the anterior surface is located 9.0</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">mm lower. In males, the hyoid is inclined more steeply than in females by 4.4 degrees and the antegonial notch is deeper than in females by 0.6</span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">mm. </span><b><span style="font-family:Verdana;">Conclusions: </span></b><span style="font-family:Verdana;">There are differences in hyoid bone position and mandibular morphology in hyperdivergent subjects compared to normodivergent subjects and in males compared to females.
文摘BACKGROUND A swallowing disorder may occur following a brainstem stroke,especially one that occurs in the swallowing centers.Lateral medullary syndrome(referred to as LMS),a rare condition in which a vascular event occurs in the territory of the posterior inferior cerebellar artery or the vertebral artery,has been reported to lead to more severe and longer lasting dysphagia.CASE SUMMARY We report two patients with dysphagia due to LMS and propose a novel technique named hyoid-complex elevation and stimulation technique(known as HEST).The two patients had no other functional incapacity back into life,but nasogastric feeding was the only possible way for nutrition because of severe aspirations.Swallowing function was evaluated by functional oral intake scale,modified water swallow test,surface electromyographic signal associated with video fluorography swallowing study to assess the situation of aspiration,pharyngeal residue,pharyngeal peristalsis,upper esophageal opening and the ability of deglutition.Both patients were treated with the HEST method for dysphagia and recovered quickly.CONCLUSION HEST is effective for shortening the in-hospital time and improving the quality of life for patients with dysphagia who suffer from LMS and likely other strokes.
文摘Objective:Determine the effects of hyoid myotomy and suspension (HMS) without concurrent palatal or tongue base sleep surgery for obstructive sleep apnea (OSA).Method:Patients with OSA treated with HMS were identified using CPT code (21685) at an academic and private sleep surgery clinic.Those who underwent concurrent palatal or tongue base sleep surgery were excluded.Outcomes included simultaneous procedures,apnea-hypopnea index (AHI),lowest oxyhemoglobin saturation (LSAT),and Epworth Sleepiness Scale (ESS).Results:Nineteen patients with OSA underwent HMS without palatal or tongue base sleep surgery.The average age at surgery was (55.3 ± 13.5) years with a majority of patients being male (71％).Concurrent procedures included the following:torus mandibularis excision (n =1),endoscopic sinus surgery (n =4),septoplasty (n =10),inferior turbinate reduction (n =12),and nasal valve repair (n =2).AHI improved signiflcantly from (39.7 ± 21.2) eventslh to (22.6 ± 22.7) events/h after HMS (P ＜ 0.01),which represented a 43％ reduction.LSAT significantly increased from (82.2％ ± 9.9％) to (86.6％ ± 6.2％),P ＜ 0.01.There was no improvement in ESS after surgery (8.2 ± 4.4) to (8.3 ± 5.2),P =0.904.A subset of patients with severe OSA (AHI ＞ 30 events/h) had an improvement in AHI from (49.9 ± 16.6) events/h to (29.1 ± 24.9) events/h,P ＜ 0.01.Conclusion:HMS without palatal or tongue base sleep surgery improves OSA severity.It can be considered as a valid option in the treatment of OSA in appropriately-selected patients.
基金Supported by the National Natural Science Foundation of China(No.81273705)。
文摘Objective:To observe the effects and safety of Tongyan Spray(通咽喷雾剂)on the range and time of hyoid motion in patients with ischemic post-stroke dysphagia.Methods:Seventy-two patients with ischemic post-stroke dysphagia were selected and randomly assigned to a treatment group(36 cases)and a control group(36 cases)by a random number table from January 2013 to October 2014.All patients swallowed 4 kinds of barium meals with different traits respectively,and each patient underwent video fluoroscopy(VF)examination twice.In the treatment group,Tongyan Spray was sprayed to the pharynx on both sides and the middle part once respectively.The spray was applied 30 min before the second examination.Purified water at room temperature was used as placebo in the control group.The changes in the range and time of hyoid motion in both groups were observed before and after treatment.Results:Six patients dropped out in each group,and 60 patients completed the study and were included in the final analysis.Significant improvement was observed in the range of superior hyoid excursion distance and the time of hyoid motion in the treatment group compared with the control group(P<0.05).There were no obvious adverse reactions observed in oral mucosa in both groups during the whole study.Conclusion:Tongyan Spray was an effective and safe medicine for improving swallowing function in patients with ischemic post-stroke dysphagia.
