• Korean Journal of Bronchoesophagology
• /
• v.13 no.2
• /
• pp.9-16
• /
• 2007

Cricopharyngeal dysphagia(CPD), a common condition in the dysphagic patient, refers to the dysfunction of the upper esophageal sphincter complex(UESC), which is composed of the cricopharyngeus, inferior pharyngeal constrictor and the upper segment of the cervical esophagus. Primary CPD is the disease entity solely confined to dysfunctional UESC, while secondary CPD encompasses various conditions that accompany UESC dysfunction. For proper diagnosis and treatment of such entity, a thorough understanding of the complex anatomy and physiology of the upper esophageal sphincter. Adequate relaxation of the cricopharyngeal muscle in conjunction with anterosuperior excursion of the larynx by suprahyoid muscles and propulsion of food bolus are prerequisite for normal swallow, mechanisms of which if altered result in cricopharyngeal dysfunction. Of the various methods used for the diagnosis of cricopharyngeal dysphagia, videofluoroscopy remains the method of choice. Mechanical dilatation of the cricopharayngeus, cricopharyngeal myotomy and botulinum toxin injection and head-lift exercise have been used in clinical practice to relieve dysphagia in such patients. Such procedures have therapeutic effect in primary CPD, but so often fail to relieve swallowing dysfunction in patient with secondary CPD. We herein explain ancillary procedures that support these primary treatment options, which lead to successful treatment of dysphagia.

• The korean journal of orthodontics
• /
• v.42 no.6
• /
• pp.318-328
• /
• 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.

• Korean Journal of Head & Neck Oncology
• /
• v.6 no.2
• /
• pp.85-90
• /
• 1990

Midline neck masses have numerous origin and it is important to diagnose correctly for management. A clinical analysis of 29 cases of midline neck masses confirmed by histopathological examination was done retrospectively during the last 5 years. The results were followings; 1) Of 29 cases, thyroglossal duct cyst was most frequent(17 cases, 58.6%) and non-specific lymphadenopathy was the next(4 cases, 13.8%). 2) Midline neck masses were most frequent on the suprahyoid area(12 cases, 41.4%) and hyoid area was the next(7 cases, 24.1%). 3) Two thyroglossal duct carcinoma was included in 17 thyroglossal duct cyst. 4) Seventy percent of thyroglossal duct cyst was present on hyoid and infrahyoid area.

• Physical Therapy Korea
• /
• v.22 no.1
• /
• pp.103-109
• /
• 2015

Although the relationship between temporomandibular disorder and forward head posture (FHP) is controversial, it is generally accepted that altered head posture can affect mandible position and masticatory muscles activity. Because suprahyoid (SH) and infrahyoid (IH) muscles are stretched by increased passive tension in FHP, this study investigated their activity during mouth opening in FHP compared to neutral head posture (NHP). Twenty healthy subjects (10 males and 10 females) participated in this study. Head postures were evaluated with a cervical range of motion instrument. Electromyography (EMG) activity of bilateral SH and IH muscles was measured while an open mouth was maintained at each head posture. Paired t-test was used to identify significant differences in normalized EMG activity between head postures. Statistical significance was set at .01. Results showed the normalized EMG activity of SH and IH muscles were significantly lower in FHP compared to NHP. This finding indicates that FHP affects the EMG activity of hyoid muscles when they are stretched.

• Journal of the Ergonomics Society of Korea
• /
• v.32 no.6
• /
• pp.541-547
• /
• 2013

Objective: The aim of this study is to find the influence on muscle fatigue by changing an angle of neck while Shaker exercise. Background: Shaker exercise is commonly applied to dysphagia patients for strengthen suprahyoid muscle(SHM) and relaxing upper esophageal sphincter. Method: Experiments were conducted by measuring muscle fatigue with surface electromyography(SEMG) in case of neck $15^{\circ}$ and $50^{\circ}$ flexion, in addition to original method. For the study 30 undergraduate students were participated as subjects. Muscle fatigue was measured with variations of median frequency(MF) and median frequency slope(MFS) by attaching SEMG to 3 muscles. At the same time, perceived exertion was measured by using Borg's rating of perceived exertion(RPE). Results: A MF was increased when low angle in SHM, both male and female. It means that muscle fatigue was significantly decreased(p<.05). RPE was significantly increased when low angle(p<.01). Perceived exertion explained 15.2% of the variation of MF in SHM. And regression equation was, MF in SHM = 59.918 + (4,910 * RPE). Conclusion: The outcome shows that it is possible to use the efficient method which makes muscle fatigue decrease by reducing the angle of neck flexion. Application: The results might contribute to develop the effective Shaker exercise method.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.19 no.3
• /
• pp.311-318
• /
• 1997

Ludwig's angina has been defined as a potentially lethal, rapidly spreading cellulitis, involving the sublingual and submandibular spaces, and is manifesed by a brawny, suprahyoid induration, tender swelling in the floor of mouth, elevation and posterior displacement of tongue. This paper is of interest not only because of severity of infection but also because of associated diabetic mellitus. Diabetes mellitus is a complex syndrome of disordered metabolism and elevated blood glucose, it results from deficiency of insulin secretion of combination of insulin resistance and inadequate insulin secretion. The effects of diabetic mellitus include neuropathy, vascular insufficiency, decreased leukocytic function, hematologic change etc. Clinically this may be refelected by the increased severity of infections seen in diabetics. The treatment of infections in diabetics are reduction of number of microbes through the use of appropriated antimicrobial agents and proper surgical drainage and improvement of the host factors by tight control of insulin replacement and immediate intervention to correct abnormalities of the local factors by drainage, debriment, and removal of avoidance of foreign bodies. The authors present the report of the Ludwig's angina in patient with diabetic mellitus, with literature review and good clinical result.

• Korean Journal of Bronchoesophagology
• /
• v.7 no.1
• /
• pp.40-45
• /
• 2001

Management of laryngotracheal stenosis remains one of the most challenging problems facing the otolaryngologist. The key to success is to obtain adequate rigid circular support with normal mucosal lining. Four Patients with laryngotracheal stenosis were surgically treated in our institution in 2000. All the patients were male adults. The cause of stenosis were longterm or repeated endotracheal intubation and tracheostomy in our patients. All patients were successfully decannulated following segmental resection of the stenotic portion including the anterior arch of the cricoid cartilage and end-to-end anastomosis after suprahyoid laryngeal release. The time between treatment and decannulation was just one day in three patients. These results suggest the Possibility of early decannulation even if the cricoid cartilage was partially resected. It is better to prevent laryngotracheal stenosis rather than to treat it once it has occurred.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.17 no.3
• /
• pp.283-288
• /
• 1995

Cystic hygroma is the benign proliferation of lymphatic tissue and has been categorized as a part of a larger spectrum that includes lymphangiomas recently. The majority of lymphangiomas occur in the head and neck as cystic hygromas with the posterior cervical region as the most common site. Cystic hygromas present in infancy or early childhood as compressible masses that may rapidly and intermittently enlarge. Cystic hygromas of the head and neck are especially difficult to manage since enlargement cause serious sequela such as airway obstruction, feeding difficulties, and speech pathology. Surgical exision remains the treatment of choice. But complete extirpation of these lesions is often impossible, and recurrence rates are accordingly different respectively ; these are high in suprahyoid lesions compared with infrahyoid involvement. This is a case report about 22 year old male patient with cystic hygrom. We obtained the successful, functional and esthetic results by surgical excision of the mass. Therefore, we report the case with literatural reviews.

• Korean Journal of Bronchoesophagology
• /
• v.4 no.1
• /
• pp.27-34
• /
• 1998

Despite improvement in respiratory care, including use of low pressure and high volume cuffed tubes, tracheal stenosis remains a serious complication after a long-term tracheal intubation and tracheostomy. In such patients, tracheal resection and primary anastomosis is still considered ideal therapeutic modality. Between 1989 and 1997, we performed tracheal resections with end-to-end anastomosis on 14 patients with no operative mortality and some morbidity. Tracheal stenosis was caused by tracheostomy in nine patients, by endotracheal intubation in three patients and by thyroid carcinoma in two patients. The length of stenosis was various from 2cm to 4.5cm. All patient underwent segmental tracheal resection and primary anastomosis(14 patients) and additional procedures were cricoid cartilage reconstruction(2 patients), suprahyoid laryngeal release(3patients), carinal release technique(2 patients) and arytenoidectomy(2 patients). We have nine complications: granulona at anastomosis site in four patients, vocal cord palsy in two patients and restenosis, pneumonia, skin necrosis in each of those patients. The granuloma was removed by bronchoscopic forceps(4 patients). Vocal cord palsy was treated by arytenoidectorny(2 patients), restenosis by T-tube insertion, pneumonia by antibiotics and skin necrosis was treated by skin graft. We reviews our expenence of clinical features of tracheal stenosis and surgical treatment by tracheal one-to-end anastomosis with additional procedures to avoid postoperative complications for sucessful results.

• Journal of Medicine and Life Science
• /
• v.15 no.1
• /
• pp.12-15
• /
• 2018

Digastric and stylohyoid muscles are located in the suprahyoid region. There have been few studies about the general morphology of stylohyoid muscle and its relationship with digastric muscle. During routine educational dissection, unusual insertion of bilateral stylohyoid muscle was found in the cadaver of a 92-year-old Korean male, whose cause of death was 'aspiration pneumonia'. Stylohyoid muscle arose from the styloid process, and inserted onto the intermediate tendon of digastric muscle and the hyoid bone on both sides. Each digastric muscle normally consists of an anterior belly, intermediate tendon and a posterior belly. In this cadaver, there were two anterior bellies on right side while one anterior belly was found on left side. Stylohyoid muscle ran medial to the intermediate tendon of digastric muscle on both sides. The anatomical relationship between stylohyoid and digastric muscles was reviewed based on morphological and embryological point of view.