• 대한인간공학회지
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• 제29권3호
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• pp.331-336
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• 2010

The purpose of this study was to identify the effect of the craniocervical posture on swallowing and hyoid bone movement with sitting posture in wheelchair, and to provide basic data for developing a treatment program for dysphagia. A total of sixty healthy adults without a history of dysphagia who were guardians or care assistants of inpatients at Hospital K underwent video fluoroscopy performed by physiatrists from April to July 2009. The results of the fluoroscopy were analyzed based on the measurement of hyoid bone movements. The hyoid bone movement(horizontal, vertical, and diagonal) was significantly high in the neutral craniocervical, chin-tuck, and sixty degrees extension postures, in descending order(p<.05). It was found that the neutral craniocervical posture is the most effective posture for hyoid bone movement with sitting posture in wheelchair.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제42권
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• pp.27.1-27.9
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• 2020

Background: Mandibular setback surgery can change the position of the mandible which improves occlusion and facial profile. Surgical movement of the mandible affects the base of the tongue, hyoid bone, and associated tissues, resulting in changes in the pharyngeal airway space. The aim of this study was to analyze the 3-dimensional (3D) changes in the hyoid bone and tongue positions and oropharyngeal airway space after mandibular setback surgery. Methods: A total of 30 pairs of cone-beam computed tomography (CBCT) images taken before and 1 month after surgery were analyzed by measuring changes in the hyoid bone and tongue positions and oropharyngeal airway space. The CBCT images were reoriented using InVivo 5.3 software (Anatomage, San Jose, USA) and landmarks were assigned to establish coordinates in a three-dimensional plane. The mean age of the patients was 21.7 years and the mean amount of mandibular setback was 5.94 mm measured from the B-point. Results: The hyoid bone showed significant posterior and inferior displacement (P < 0.001, P < 0.001, respectively). Significant superior and posterior movements of the tongue were observed (P < 0.05, P < 0.05, respectively). Regarding the velopharyngeal and glossopharyngeal spaces, there were significant reductions in the volume and minimal cross-sectional area (P < 0.001). The anteroposterior and transverse widths of the minimal cross-sectional area were decreased (P < 0.001, P < 0.001, respectively). In addition, the amount of mandibular setback positively correlated with the amount of posterior and inferior movement of the hyoid bone (P < 0.05, P < 0.05, respectively). Conclusion: There were significant changes in the hyoid bone, tongue, and airway space after mandibular setback surgery.

• 한국전문물리치료학회지
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• 제26권3호
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• pp.76-83
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• 2019

Background: The hyoid bone is the only non-jointed structure among the skeletal tissues of the head and neck region, and its movement and posture depend on the attached muscle, ligament, and fascia. The location of the hyoid bone is important for airway maintenance, vocalization, chewing, swallowing, breathing, and head and scapular position. In general, the location of the hyoid bone is measured using radiographs and 3D computed tomography, and no studies have reported on clinical measurement methods. Objects: This study was performed to suggest clinical measurement methods for lateral deviation of the hyoid bone and to evaluate their reliability. Methods: In this study, 24 healthy volunteers (12 males, 12 females) in Cheongju-si participated. Two examiners performed the center point test and lateral motion test twice each to measure the lateral displacement of the hyoid bone. The reliability of the center point test was analyzed using intra-class correlation coefficients (ICC), and the reliability of the lateral motion test was analyzed using Cohen's kappa coefficient. Results: The intra-rater reliability of the center point test was good, and the inter-rater reliability was moderate. The intra- and inter-rater reliability of the lateral motion test showed substantial reliability. Conclusion: Based on these results, the center point test and the lateral motion test can be used as an alternative methods of the measurement of lateral deviation of the hyoid bone for people who have musculoskeletal disorders of the head, neck, and scapula.

• 대한치과교정학회지
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• 제42권6호
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• pp.318-328
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• 2012

Objective: To assess the position and movements of the hyoid bone during deglutition in patients with open bite. Methods: Thirty-six subjects were divided into 2 groups according to the presence of anterior open bite. The open bite group (OBG) and control group each comprised 18 patients with a mean overbite of $-4.9{\pm}1.9$ mm and $1.9{\pm}0.7$ mm. The position of the hyoid bone during the 4 stages of deglutition was evaluated by measuring vertical and horizontal movement of the bone. Results: Interactions of group and stage showed no significant effect on the measurements (p > 0.05). However, when group and stage were evaluated individually, they showed significant effects on the measurements (p < 0.001). In OBG, the hyoid bone was more inferiorly and posteriorly positioned, and this position continued during the deglutition stages. Conclusions: The hyoid bone reaches the maximum anterior position at the oral stage and maximum superior position at the pharyngeal stage during deglutition. Open bite does not change the displacement pattern of the bone during deglutition. The hyoid bone is positioned more inferiorly and posteriorly in patients with open bite because of released tension on the suprahyoid muscles.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제37권
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• pp.38.1-38.6
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• 2015

Background: The posterior movement of mandible was known as the main cause of the changes in the pharyngeal airway space (PAS) and the postoperative obstructive sleep apnea (OSA). The purpose of this study was to know the changes of PAS and position of hyoid bone. Methods: Lateral cephalographies of 13 patients who had undergone sagittal split ramus osteotomy (SSRO) setback surgery were taken preoperatively (T1), postoperatively within 2 months (T2), and follow-up after 6 months or more (T3). On the basis of F-H plane, diameters of nasopharynx, oropharynx, and hypopharynx were measured. The movements of the soft palate, tongue, and hyoid bone were also measured. Results: The amount of mandible setback was $7.5{\pm}3.8mm$. In the measurements of PAS, there was a statistically significant decrease of $2.8{\pm}2.5mm$ in nasopharynx (P < 0.01), and $1.7{\pm}2.4mm$ in oropharynx (P < 0.01) were observed after surgery. The hypopharynx decreased $1.0{\pm}2.1mm$ after surgery and continuously decreased $1.0{\pm}2.8mm$ at follow-up. The changes in hyoid bone position showed the posterior movement only after surgery and posteroinferior movement at follow-up. Conclusions: The PAS such as nasopharynx, oropharynx, and hypopharynx showed relatively high correlation with the amount of mandibular setback. The change of resistance in upper airway may be important for the prevention of OSA after mandibular setback surgery.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제41권5호
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• pp.224-231
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• 2015

Objectives: The purpose of this study was to evaluate changes in the pharyngeal airway space and hyoid bone position after mandibular setback surgery with bilateral sagittal split ramus osteotomy (BSSRO) and to analyze the correlation between the amount of mandibular setback and the amount of change in pharyngeal airway space or hyoid bone position. Materials and Methods: From January 2010 to February 2013, a total of 30 patients who were diagnosed with skeletal class III malocclusion and underwent the same surgery (BSSRO) and fixation method in the Division of Oral and Maxillofacial Surgery, Department of Dentistry at the Ajou University School of Medicine (Suwon, Korea) were included in this study. Lateral cephalograms of the 30 patients were assessed preoperatively (T1), immediately postoperatively (T2), and 6 months postoperatively (T3) to investigate the significance of changes by time and the correlation between the amount of mandibular setback and the amount of change in the airway space and hyoid bone position. Results: Three regions of the nasopharynx, oropharynx, and hypopharynx were measured and only the oropharynx showed a statistically significant decrease (P<0.01). A significant posterior and inferior displacement of the hyoid bone was found 6 months after surgery (P<0.01). Analysis of the correlation between the amount of mandibular setback and the amount of final change in the airway space and hyoid bone position with Pearson's correlation showed no significant correlation. Conclusion: In this study, the oropharynx significantly decreased after mandibular setback surgery, and changes in the surrounding structures were identified through posteroinferior movement of the hyoid bone during long-term follow-up. Therefore, postoperative obstructive sleep apnea should be considered in patients who plan to undergo mandibular setback surgery, and necessary modifications to the treatment plan should also be considered.

• 한국전문물리치료학회지
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• 제27권1호
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• pp.70-77
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• 2020

Background: Neck pain can be caused by any structure in the neck, such as intervertebral discs, ligaments, muscles, facet joints, dura mater, and nerve roots. The hyoid bone is a structure that is also related to head and neck posture, neck movement and pain, but there are no studies on hyoid deviation, neck pain, and range of motion (ROM). Objects: The purpose of this study was to investigate the effect of fascia relaxation and mobilization of the hyoid bone on the ROM, pain, and lateral deviation of the hyoid bone. Methods: Twenty-five patients with neck pain identified by the lateral motion test (10 males [35.13 ± 7.67 years, 172.69 ± 3.90 cm, 78.77 ± 6.96 kg] and 15 females [35.13 ± 10.05 years, 161.11 ± 4.09 cm, 52.59 ± 2.98 kg]) was chosen randomly. Baseline values for pain, neck ROM, and lateral deviation in the hyoid bone were recorded using a visual analogue scale (VAS), goniometer, and tape measure. Then, each patient was treated with hyoid fascia relaxation and mobilization, and all results were recorded after intervention. Comparison of the results before and after intervention was analyzed using paird t-test (p < 0.05). Results: Right rotation, extension, VAS, and rotational asymmetry statistically significant differences (p < 0.05). Right rotation and extension increased ROM, rotational asymmetry ratio and VAS decreased. However, there was no significant difference in flexion, left rotation, center point (p > 0.05). Conclusion: Fascia relaxation and hyoid mobilization could improve the ROM of cervical extension, asymmetry of the cervical rotation and neck pain.

• Archives of Plastic Surgery
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• 제38권2호
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• pp.199-202
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• 2011

Purpose: Hyoid bone is a U-shaped bone in the anterior of the neck. Hyoid bone fractures are exceedingly rare and represent only 0.002% of all fractures because of its protective position relative to the mandible and its suspension by elastic musculature. We report a patient who presented hyoid bone fracture associated with hypoglossal nerve palsy. We also discuss the possible complication and treatment. Methods: A 69-year-old man was transferred from another institution because of persistent purulent discharge from the left chin. He had a history of trauma in which a knuckle crane grabbed his face and neck in the construction site. A CT scan at the time of the accident demonstrated a comminuted fracture of the right side of the mandible and hyoid bone fracture at the junction between body and right greater cornua. The displaced fracture of hyoid bone and fullness in the pre-epiglottic space were noted, probably indicating some edema. The patient was transferred into ICU after treatment of emergency tracheostomy because the patient showed respiratory distress rapidly. When the patient was hospitalized in our emergency room, he complained of dysphagia and pain when swallowing. On examination of oral cavity, the presence of muscle wasting with fasciculation of the tongue was noted and the tongue deviates to the left side on protruding from the mouth. Pharyngolarygoscopy was performed to make sure that there was no evidence of progressive swelling and pharyngeal laceration. Results: The patient underwent surgical removal of dead and infected tissue from the wound and reconstruction of mandibular bony defect by iliac bone grafting. Hyoid bone fracture was managed conservatively with oral analgesics, soft diet and restricted movement. Hypoglossal nerve palsy was resolved within 7 weeks after trauma without complications. Conclusion: Closed hyoid bone fracture is usually uncomplicated and thus it can be treated conservatively. Surgical intervention for hyoid bone fracture is recommended for patient with airway compromise, pharyngeal perforation and painful symptoms which show no response to conservative care. Furthermore, since respiratory distress syndrome may develop quickly, close observation is required. Besides, hypoglossal nerve palsy is a rarely recognized complication of hyoid bone fracture.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제26권2호
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• pp.164-171
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• 2000

Purpose : This study was aimed at measuring the changes in the hyoid bone position, tongue position, and pharyngeal airway space in subjects with mandibular setback osteotomies. Methods : Twenty patients were evaluated retrospectively for their changes in pharyngeal airway space, tongue and hyoid bone positions. All patients underwent surgical mandibular setback using bilateral sagittal split osteotomies. The cephalometric analysis was performed preoperatively, and 1 week, 3-6 months, and 1 year postoperatively. Result : The hyoid bone moved inferiorly and posteriorly immediately after surgery, and it returned to the preoperative position during follow-up period. The nasopharyngeal airway space was not significantly changed after surgery. A considerable decrease in the oropharyngeal and hypopharyngeal airway spaces following mandibular setback surgery was found. The upper and lower tongue was posteriorly repositioned immediately after surgery. During follow-up period, the hypopharyngeal airway space and lower tongue posture returned to the preoperative positions, but the oropharyngeal airway space and upper tongue posture were not significantly changed. The position of pogonion remarkably changed to backward immediately after surgery, but slightly anterior advancement was found during follow-up period. Conclusion : Immediately after mandibular setback surgery, the oropharyngeal and hypopharyngeal airway spaces obviously decreased due to posterior and inferior repositions of the tongue and hyoid bone. During follow-up period, lower tongue and hyoid bone returned to the preoperative positions, it was related to advancement of the pogonion in this period. The narrowing of the oropharyngeal airway space and posterior movement of the upper tongue posture were relatively permanent after mandibular setback surgery. We suspected this phenomenon had an influence on maintaining the total volume of oral cavity against mandibular setback.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제41권
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• pp.51.1-51.8
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• 2019

Purpose: It has been reported before that the amount of pharyngeal airway space (PAS) significantly decreases following mandibular setback (MS) surgery in patients with mandibular prognathism (MP). Further, MP patients with an anterior open-bite (AOB) presentation may show a larger decrease in PAS compared with those without AOB. However, studies on postoperative PAS changes in MP patients with AOB remain rare. This study sought to evaluate changes in PAS and hyoid bone positioning following MS surgery in MP patients with and without AOB. Patients and methods: Twenty patients who underwent two jaw surgery involving MS movement were included. Patients were divided into a non-AOB group (n = 10; overbite > 2 mm) and an AOB group (n = 10; overbite < - 4 mm). Three-dimensional changes in PAS and hyoid bone positioning were compared and statistically evaluated pre- and postoperatively using computed tomography (CT). Results: The mean magnitude of MS was 6.0 ± 2.8 mm and 5.6 ± 3.2 mm in the non-AOB group and AOB group, respectively. The oropharyngeal volume and upper hypopharyngeal volume were significantly reduced after surgery in both the groups (p = 0.006 and p = 0.003), while the retroglossal cross-sectional area was significantly reduced only in the AOB group (p = 0.028). Although the AOB group showed a larger decrease in PAS, the difference was not statistically significant between the groups. The position of the hyoid bone showed significant posterior and inferior displacement only in the AOB group, while the vertical displacement of the hyoid bone showed a statistically significant difference between the two groups. Conclusion: PAS was significantly decreased after MS in both the groups, while only the AOB group presented a statistically significant reduction in the retroglossal cross-sectional area. Vertical displacement of the hyoid bone showed a statistically significant difference between the groups, while the PAS change was not. Surgeons should be aware of potential postoperative airway problems that may arise when performing MS surgeries.