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Anatomical diversity of inferior belly of the omohyoid muscle - Anatomical, physiological and surgical paradigm. Morphologie 2023; 107:142-146. [PMID: 35148950 DOI: 10.1016/j.morpho.2022.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 01/24/2022] [Accepted: 01/25/2022] [Indexed: 11/23/2022]
Abstract
Omohyoid muscle is one of the infrahyoid muscles of the neck which consists of two bellies combined at an angle by an intermediate tendon. The inferior belly is a flat, narrow band, which inclines forwards and upwards in the lower part of the neck. It generally originates from the upper border of the scapula, medial to scapular notch. The present case showed unilateral anomalous attachment of the inferior belly of the omohyoid on the medial part of clavicle on left side. Inferior belly was 2.2cm lateral to left sternoclavicular joint with 3.2 and 1.5cm in length and breadth, innervated by ansa cervicalis. Only 3% of this type of variation has been observed until now according to previous literature. Anterior and posterior triangles of neck on both sides of the cadaver were dissected during routine dissection for undergraduate teaching. There was no scapular attachment of inferior belly of the omohyoid on the left side. It was directly originating from the upper surface of the medial side of the left clavicle. Variation in the attachment of inferior belly can have a direct impact on the internal jugular vein and brachial plexus during neck surgeries or trauma due to its close relation to the mentioned structures. This variation should also be taken care during infrahyoid myocutaneus flap extraction for reconstruction surgery of tongue in cases of lingual carcinoma.
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Thangarajan R, Shetty P, Sirasanagnadla SR, D'souza MR. Unusual morphology of the superior belly of omohyoid muscle. Anat Cell Biol 2014; 47:271-3. [PMID: 25548726 PMCID: PMC4276902 DOI: 10.5115/acb.2014.47.4.271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 04/03/2014] [Accepted: 04/28/2014] [Indexed: 11/27/2022] Open
Abstract
Though anomalies of the superior belly of the omohyoid have been described in medical literature, absence of superior belly of omohyoid is rarely reported. Herein, we report a rare case of unilateral absence of muscular part of superior belly of omohyoid. During laboratory dissections for medical undergraduate students, unusual morphology of the superior belly of the omohyoid muscle has been observed in formalin embalmed male cadaver of South Indian origin. The muscular part of the superior belly of the omohyoid was completely absent. The inferior belly originated normally from the upper border of scapula, and continued with a fibrous tendon which ran vertically lateral to sternohyoid muscle and finally attached to the lower border of the body of hyoid bone. The fibrous tendon was about 1 mm thick and received a nerve supply form the superior root of the ansa cervicalis. As omohyoid mucle is used to achieve the reconstruction of the laryngeal muscles and bowed vocal folds, the knowledge of the possible anomalies of the omohyoid muscle is important during neck surgeries.
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Affiliation(s)
- Rajesh Thangarajan
- Department of Anatomy, Melaka Manipal Medical College (Manipal Campus), Manipal University, Manipal, Karnataka, India
| | - Prakashchandra Shetty
- Department of Anatomy, Melaka Manipal Medical College (Manipal Campus), Manipal University, Manipal, Karnataka, India
| | - Srinivasa Rao Sirasanagnadla
- Department of Anatomy, Melaka Manipal Medical College (Manipal Campus), Manipal University, Manipal, Karnataka, India
| | - Melanie Rose D'souza
- Department of Anatomy, Melaka Manipal Medical College (Manipal Campus), Manipal University, Manipal, Karnataka, India
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Zhao W, Liu J, Xu J, Wang H. Duplicated posterior belly of digastric muscle and absence of omohyoid muscle: a case report and review of literature. Surg Radiol Anat 2014; 37:547-50. [PMID: 25218516 DOI: 10.1007/s00276-014-1374-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Accepted: 09/04/2014] [Indexed: 11/29/2022]
Abstract
PURPOSE We report a unique case of duplicated posterior belly of digastric muscle and absence of omohyoid muscle, review literatures and discuss its clinical importance. MATERIALS AND METHODS An abnormal strip of muscle was found during the routine functional neck dissection in a 58-year-old man, who suffered from moderately differentiated squamous cell carcinoma of right tongue. We check the anatomical features and search for similar variations in the past literatures. RESULTS The abnormal strip of muscle was attached to mastoid process, passed anteroinferiorly into the infrahyoid muscles. The muscle was as long as, but narrower than the posterior belly of the digastric muscle. So far, only one case of this anomaly was reported. Meanwhile, the omohyoid muscle was confirmed to be absent in the right neck of this patient. CONCLUSIONS To our knowledge, report of variations of both digastric muscle and omohyoid muscle, this variation mostly derives from abnormal development of the mesenchyme in the branchial arches. Attention should be paid to such variations, which might influence surgical procedures.
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Affiliation(s)
- Wenquan Zhao
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, People's Republic of China
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Kim DI, Kim HJ, Park JY, Lee KS. Variation of the infrahyoid muscle: duplicated omohyoid and appearance of the levator glandulae thyroideae muscles. Yonsei Med J 2010; 51:984-6. [PMID: 20879073 PMCID: PMC2995959 DOI: 10.3349/ymj.2010.51.6.984] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
The embryologic origin of the omohyoid muscle is different from that of the other neck muscles. A number of variations such as the absence of muscle, variable sites of origin and insertion, and multiple bellies have been reported. However, variations in the inferior belly of the omohyoid muscle are rare. There have been no reports of the combined occurrence of the omohyoid muscle variation with the appearance of the levator glandulase thyroideae muscle. Routine dissection of a 51- year-old female cadaver revealed a duplicated omohyoid muscle and the appearance of the levator glandulae thyroideae muscle. In this case, the two inferior bellies of the omohyoid muscle were found to originate inferiorly from the superior border of the scapula. One of the inferior bellies generally continued to the superior belly with the tendinous intersection. The other inferior belly continued into the sternohyoid muscle without the tendinous intersection. In this case, the levator glandulae thyroideae muscle appeared on the left side, which attached from the upper border of the thyroid gland to the inferior border of the thyroid cartilage. These variations are significant for clinicians during endoscopic diagnosis and surgery because of the arterial and nervous damage due to iatrogenic injuries. The embryologic origins of the omohyoid and levator glandulae thyroideae muscles may be similar based on the descriptions in the relevant literature.
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Affiliation(s)
- Deog-Im Kim
- Department of Anatomy, Catholic Institution for Applied Anatomy, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ho-Jeong Kim
- Department of Anatomy, Kwandong University College of Medicine, Gangneung, Korea
| | - Jae-Young Park
- Department of Anatomy, Kwandong University College of Medicine, Gangneung, Korea
| | - Kyu-Seok Lee
- Department of Anatomy, Kwandong University College of Medicine, Gangneung, Korea
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Kingham PJ, Hughes A, Mitchard L, Burt R, Murison P, Jones A, Terenghi G, Birchall MA. Effect of neurotrophin-3 on reinnervation of the larynx using the phrenic nerve transfer technique. Eur J Neurosci 2007; 25:331-40. [PMID: 17284173 DOI: 10.1111/j.1460-9568.2007.05310.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Current techniques for reinnervation of the larynx following recurrent laryngeal nerve (RLN) injury are limited by synkinesis, which prevents functional recovery. Treatment with neurotrophins (NT) may enhance nerve regeneration and encourage more accurate reinnervation. This study presents the results of using the phrenic nerve transfer method, combined with NT-3 treatment, to selectively reinnervate the posterior cricoarytenoid (PCA) abductor muscle in a pig nerve injury model. RLN transection altered the phenotype and morphology of laryngeal muscles. In both the PCA and thyroarytenoid (TA) adductor muscle, fast type myosin heavy chain (MyHC) protein was decreased while slow type MyHC was increased. These changes were accompanied with a significant reduction in muscle fibre diameter. Following nerve repair there was a progressive normalization of MyHC phenotype and increased muscle fibre diameter in the PCA but not the TA muscle. This correlated with enhanced abductor function indicating the phrenic nerve accurately reinnervated the PCA muscle. Treatment with NT-3 significantly enhanced phrenic nerve regeneration but led to only a small increase in the number of reinnervated PCA muscle fibres and minimal effect on abductor muscle phenotype and morphology. Therefore, work exploring other growth factors, either alone or in combination with NT-3, is required.
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Affiliation(s)
- Paul J Kingham
- Blond McIndoe Research Laboratories, Plastic and Reconstructive Surgery Research, Stopford Building, University of Manchester, Oxford Road, Manchester, M13 9PT, UK.
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Hatipoğlu ES, Kervancioğlu P, Tuncer MC. An unusual variation of the omohyoid muscle and review of literature. Ann Anat 2006; 188:469-72. [PMID: 16999212 DOI: 10.1016/j.aanat.2006.03.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The omohyoid muscle is important in radical neck dissection, as it is a landmark for this operation. Because it divides the anterior and posterior cervical triangles into smaller triangles and its particular relationship to the large cervical vessels, the presence of an anatomical variation of the omohyoid muscle is important. An unfamiliar muscle was found in the left anterior cervical region of a 57-year-old male cadaver. It was attached at its caudal end to the clavicle and coursed upward to the hyoid bone and a normal omohyoid muscle with its intermediate tendon was lateral to this muscle. Both the muscles joined together near the hyoid bone and both muscles attached to the hyoid bone with the same tendon. According to its origin and insertion, the unfamiliar muscle was considered to be the cleido-hyoideus muscle. In our case report, a variant of infrahyoid muscles is presented. Such an association constitutes an exceedingly rare condition.
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Affiliation(s)
- Eyüp Savaş Hatipoğlu
- Department of Anatomy, Faculty of Medicine, University of Dicle, Diyarbakir, Turkey
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Tóth A, Szucs A, Harasztosi C, Matesz K, Pucsok K, Mikó I, Sziklai I. Intrinsic laryngeal muscle reinnervation with nerve-muscle pedicle. Otolaryngol Head Neck Surg 2005; 132:701-6. [PMID: 15886621 DOI: 10.1016/j.otohns.2005.01.045] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To test the application of the nerve-muscle pedicle (NMP) technique for selective reinnervation of previously denervated posterior cricoarytenoid (PCA) muscle. METHODS The left recurrent laryngeal nerve (RLN) was severed in 5 mongrel dogs, and an ansa cervicalis-sternohyoid muscle pedicle was sutured to the left PCA muscle. Three dogs underwent a sham operation. Videolaryngoscopy was performed, and electromyographic data were collected after 1 year on average. Finally, histologic analysis of the NMP was performed. RESULTS The video records showed the return of mobility of the PCA muscle reinnervated by the NMP. EMG data as to show evoked polyphasic potentials showed also evidence of reinnervation of the PCA muscle. With immunohistochemical reaction (antineurofilament antibody+biotin) we could show neurofilaments and motor endplates in both sides in all 5 animals. CONCLUSIONS The NMP technique could eliminate the need for arytenoidectomy and laterofixation in patients with unilateral or bilateral vocal fold paralysis. The quality of life and voice may be improved.
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Affiliation(s)
- Andrea Tóth
- Department of Otolaryngology-Head and Neck Surgery, Medical and Health Science Centre, University of Debrecen, 4012 Debrecen, Nagyerdei krt. 98, Hungary.
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Abstract
An unusual origin of the right omohyoid muscle was found during cadaveric dissection. The muscle originated from the transverse process of C6 and inserted into the scapula. No other muscular anomalies of the neck were found. Although many anomalies of the omohyoid muscle have been described, a proximal attachment to the cervical spine is apparently quite rare. Knowledge of the many anomalies that can potentially occur in the cervical region is necessary in routine surgical intervention of this area. We believe this to be the first reported instance of the superior belly of the "omo" hyoid originating from the cervical region as we have described.
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Affiliation(s)
- R Shane Tubbs
- Department of Cell Biology University of Alabama at Birmingham, Birmingham, Alabama, USA.
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Heaton JT, Kobler JB, Goldstein EA, McMahon TA, Barry DT, Hillman RE. Recurrent laryngeal nerve transposition in guinea pigs. Ann Otol Rhinol Laryngol 2000; 109:972-80. [PMID: 11051439 DOI: 10.1177/000348940010901012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Improved control of prosthetic voice aids for laryngectomees might be possible to obtain with residual laryngeal motor nerve signals. We were able to recover motor signals from the recurrent laryngeal nerve (RLN) by transposing it into the ipsilateral denervated sternohyoid muscle (SH) in 8 guinea pigs. Reinnervation was monitored by electromyographic recordings from surface and intramuscular needle electrodes in awake animals. Within 4 to 14 weeks after surgery, all animals demonstrated laryngeal-like motor activity in the reinnervated SH, including activity during respiration, sniffing, swallowing, and/or vocalizing. After 3 to 6 months, the animals were reanesthetized, and nerve stimulation and section experiments confirmed the RLN as the source of reinnervation in all cases. In several animals, activity of the RLN-innervated SH was demonstrated to be correlated with that of contralateral laryngeal muscles. Histochemical analysis of the SH indicated a unilateral transformation from mostly fatigable to mostly fatigue-resistant fiber types ipsilateral to the RLN transposition, a phenotype more typical of laryngeal muscles. Thus, RLN transposition at the time of laryngectomy may be a method for salvaging laryngeal control signals that could be used to control prosthetic voice devices.
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Affiliation(s)
- J T Heaton
- Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA
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Gardner GM. Posterior glottic stenosis and bilateral vocal fold immobility: diagnosis and treatment. Otolaryngol Clin North Am 2000; 33:855-78. [PMID: 10918665 DOI: 10.1016/s0030-6665(05)70248-6] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Posterior glottic stenosis and bilateral vocal fold immobility cause obstruction of the airway at the glottis. Presentation of this problem may vary according to the cause. Full evaluation of the status of the larynx is crucial with regard to the mobility of the arytenoid cartilage and innervation of the laryngeal musculature. There are many techniques for surgically treating this condition, each with advantages and disadvantages. The surgeon should be familiar with a variety of these procedures and be able to adapt to each patient's situation.
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Affiliation(s)
- G M Gardner
- Department of Otolaryngology-Head and Neck Surgery, Henry Ford Hospital, Detroit, Michigan 48202, USA.
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Yin SS, Qiu WW, Stucker FJ, Hoasjoe DK, Aarstad RF. Evaluation of bilateral vocal fold dysfunction: paralysis versus fixation, superior versus recurrent, and distal versus proximal to the laryngeal nerves. Am J Otolaryngol 1997; 18:9-18. [PMID: 9006671 DOI: 10.1016/s0196-0709(97)90042-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- S S Yin
- Department of Otolaryngology-Head and Neck Surgery, Louisiana State University Medical Center, Shreveport 71130-3932, USA
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Doyle PJ, Chepeha DB, Westerberg BD, Schwarz DW. Phrenic nerve reinnervation of the cat's larynx: a new technique with proven success. Ann Otol Rhinol Laryngol 1993; 102:837-42. [PMID: 8239343 DOI: 10.1177/000348949310201103] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Reinnervation of the posterior cricoarytenoid muscle (PCA) should provide vocal cord abduction on inspiration, and passive adduction to enable phonation. Previous investigators have shown that reinnervation is possible, but results have not been clinically encouraging. When reinnervation was successful, the question remained whether it was provided by the transplanted nerve or by the ingrowth of adjacent nerves. In this study the phrenic nerve was transplanted directly into the PCA in a series of 12 cats. Fibrin glue was used to overcome nerve trauma and to prevent retraction of the nerve from the PCA. Laryngoscopy, electromyography, and retrograde labeling of the phrenic motoneurons provided evidence of functional reinnervation in 9 cats. Partial or complete failure in the remaining 3 was due to retraction of the nerve from the muscle. These results appear to justify trials of the procedure in humans.
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Affiliation(s)
- P J Doyle
- Division of Otolaryngology, St. Paul's Hospital, University of British Columbia, Vancouver, Canada
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