Omohyoid muscle syndrome

Omohyoid muscle syndrome is a rare cause of a bulging lateral neck mass that occurs on swallowing that often a worrisome observation because of the concern of malignancy and cosmetic deformity. The first case has been documented on 1969. A 12 years old male came to Surgical Oncology Outpatient Clinic with chief complaint a protruding right lateral neck mass during swallowing. He noticed this complaint since three months prior. He had no previous history of medical illness. He had history of multiple chokehold trauma when playing with his friend 6 months ago. He had no symptoms besides the mass occurring on his right neck. The patient went through the cervical radiograph and neck ultrasonography examination. There were inconclusive results. The patient was informed that the implication of these findings was strictly cosmetic and did not pose any risk of long-term consequence. Corrective cosmetic surgery was recommended as an option if he was concerned about the cosmetic appearance and conservative management was recommended to observe any pain or dysphagia he might experience in the near future. He denied surgery and did not seek further care for his condition. Omohyoid muscle syndrome is a rare condition that might occur after trauma such as chokehold to the neck. Imaging on this syndrome quite challenging especially when there were no other symptoms experienced. If it is proven to be strictly cosmetic, most patients will choose to have a conservative therapy.

Osteosarcoma of the Skull: An Unusual Presentation in the Left Parietal-Occipital Region

Osteosarcoma (OS) is an uncommon primary malignant brain tumor. The incidence of osteosarcoma of the skull is low with an estimated 3.4 cases per million reported per year. We report a case of OS of the skull in an 18-year-old female patient. She had complained of swelling on the left side of the head accompanied with frequent headache and diminished vision in the left eye. An PET-CT of the skull revealed a large 93x90 mm lesion in the left parietal-occipital region. Osteoblastic osteogenic sarcoma of the skull was confirmed histopathologically. The patient received six cycles of Adriamycin and cisplatin; is under close observation and currently doing well. It is empirical to report case reports, specifically unusual cases like OS of the skull. Case reports not only help disseminate knowledge but also help streamline diagnostic and treatment approaches for unusual cases.

Concomitant Occurrence of Fenestrated Internal Jugular Vein and Sub-omohyoid External Jugular Vein: A Case Report

External jugular vein is the superficial vein of the neck and is prone to variations. Multiple internal jugular veins are incidental findings that present as a duplication or fenestration. We encountered a unilateral fenestrated internal jugular vein and a bilateral variation in the course of external jugular vein, during a cadaveric dissection. The external jugular vein, after its formation, crossed the sternocleidomastoid muscle and pierced the investing cervical fascia of the posterior triangle. It traversed deep to the inferior belly of omohyoid muscle to enter the subclavian triangle and terminated by draining into the subclavian vein on the left side, and at the angle between the internal jugular vein and the subclavian vein on the right side. The fenestrated internal jugular vein on the left side divided into a small medial and large lateral division which reunited at the level of the tendon of omohyoid muscle and drained into the subclavian vein. Only the medial division of the internal jugular vein received tributaries in the neck. Awareness of the multiple variations of the jugular veins would be valuable during surgical approaches to the neck. Present report aims to be useful for vascular surgeons, radiologists, and intensivists as well.

De músculo omohioideo a músculo escapulohioideo / From omohyoid muscle to scapulohyoid muscle

Terminologia Anatomica se encuentra bajo constante revisión. A pesar de esto, continúan existiendo confusiones sobre el término correcto a utilizar pada cada estructura, en particular en español, ya que no existe una traducción oficial de Terminologia Anatomica en este idioma. Es conocido que el hueso antes llamado "omóplato" pasó a denominarse "escápula" pero aún no es oficial el cambio de nombre del músculo omohioideo, lo que se contrapone a una de las recomendaciones del Comité Federativo Internacional de Terminología anatómica que el término debe adaptarse al idioma vernáculo y su denominación debe concentrar la información y el papel descriptivo de la estructura en cuestión. Es por esto que hacemos un breve análisis del término M. omohyoideus (A04.2.04.003) Omohyoid en inglés y M. omohioideo en español. Se realizó una revisión en el diccionario de la Universidad de Salamanca y en textos antiguos de anatomía, además de observación directa por disección de cadáver. Sugiriendo renombrar el músculo, en Terminologia Anatomica, de M. omohyoideus a M. scapuhyoideus, M. Scapulohyoid, M. escápulohioideo.

Terminologia Anatomica is under constant revision. Despite this, confutions about the correct term used for each structure still exist, particularly in spanish because an official translation in this language does not exist. It is widly known that the bone named before as omoplato ("shoulder blade") now it is call "scapula" but still, the change of the Omohyoid muscle, is not official, in opposition to Federal International Committee on Anatomical Terminology recommendation that the term has to adapt to the vernacular language and it denomination has to concentrate the information and the descriptive rol of the specific structure. Because of this, a short analysis of the term M. omohyoideus (A04.2.04.003), Omohyoid Muscle and M. omohioideo (in spanish) was made. Universidad de Salamanca dictionary, ancient anatomy texts and direct cadaver observation by dissection were used. Suggesting the muscle rename in Terminologia Anatomica, from M. omohyoideus to M. scapulohyoideus, M. Scapulohyoid, M. escapulohioideo.

The Proximal Approach in an Ultrasound-Guided Suprascapular Nerve Block / 대한정형외과학회잡지

PURPOSE: The purpose of this study was to analyze any effectiveness, advantages, and the procedure of an ultrasound-guided suprascapular nerve block via the proximal approach in patients suffering from shoulder pain. MATERIALS AND METHODS: A total of 51 patients treated with nerve block between November 2015 and November 2016 were analyzed. We identified the suprascapular nerve that branches off the superior trunk of the brachial plexus, and found the suprascapular nerve, which is located in the fascial layer between the inferior belly of the omohyoid muscle and the serratus anterior muscle. We then performed a nerve block. We evaluated the visual analogue scale (VAS) of pre- and post-nerve block, and the visualization of the nerve, depth from the skin to the nerve, angle of needle entry, as well as complications. Moreover, we measured the visualization of the nerve, depth from the skin to the nerve in a classic approach, and compared it with the proximal approach. RESULTS: There was significant improvement (p < 0.05) in the mean VAS, from 7.1 to 3.4, without any major complications. Compared with the classic approach, we were able to identify the suprascapular nerve much better (classic 25.5%/proximal 96.1%), and the mean distance from the skin to the nerve (classic 38 mm/proximal 12 mm) was significantly short (p < 0.05), and the mean angle of needle entry was 19 degrees in the proximal approach. CONCLUSION: In an ultrasound-guided suprascapular nerve block by proximal approach, the nerve and needle tip can be more easily identified, which increases accuracy; with a small amount of local anesthetic, more effective pain control can be achieved. Hence, this approach is an effective alternative pain control method for patients suffering from shoulder pain.

Value of jugulo-omohyoid lymph nodes in predicting lateral cervical occult metastasis in patients with papillary thyroid carcinoma / 中华肿瘤杂志

Objective@#To investigate the value of jugulo-omohyoid lymph nodes (JOHLN) in predicting occult lateral cervical lymph node metastasis in patients with papillary thyroid carcinoma (PTC).@*Methods@#The clinicopathological data of 136 out of 2 100 PTC patients, who had a high risk of lateral neck lymph node metastasis and treated by us from January 2010 to December 2015, were retrospectively analyzed. Super selective neck dissection (SSND, level Ⅲ and Ⅳ)was performed and JOHLNs were sent for frozen section in all the 136 cases. The clinicopathological data was analyzed and the significance of JOHLN in predicting lateral cervical LNM was calculated using the SPSS software package.@*Results@#Of the 136 patients, total thyroidectomy was performed in 76 cases (55.9%) and unilateral lobectomy plus isthmus was performed in the other 60 cases (44.1%). SSND was performed in 72 patients (52.9%), level Ⅱ-Ⅳ dissection in 15 (11.0%), and level Ⅱ-Ⅴ dissection in 49 (36.0%). According to the pathological results, 38 patients were pN0(27.9%), 18 (13.2%) were pN1a and 80 (58.8%) were pN1b. The lymph node metastasis(LNM) rates at level Ⅱ-Ⅵ were 19.9%, 43.4%, 42.6%, 2.9%, and 59.6%, respectively. The sensitivity, specificity and accuracy of JOHLN in predicting lateral neck metastasis were 58.8%, 62.9%, and 76.7%, respectively. The rates for predicting level Ⅱ metastasis were 81.5%, 43.2%, and 59.4%, respectively. None of the patients died in the follow-up. Only 1 recurrence was found in level Ⅱ and regional control was achieved after level Ⅱ and Ⅴ dissection.@*Conclusions@#JOHLN has a high accuracy for predicting lateral cervical lymph node metastasis and high sensitivity for level Ⅱ metastasis. For patients with high risk of lateral cervival metastasis, super-selective neck dissection including level Ⅲ and Ⅳ can confirm the stage and reduce the risk of reoperation. Dissection for level Ⅱ, Ⅲ, and Ⅳ is recommended.

Unilateral Absence of the Sternohyoid Muscle with Contralateral Tendinous Belly of Superior Belly of Omohyoid Muscle: A Very Rare form of Infrahyoid Muscle Variation.

The sternohyoid, sternothyroid, thyrohyid and omohyoid constitute the infrahyoid group of anterior neck muscles. All these muscles are supplied by Ansa crvicalis related to the anterior wall of carotid sheath. During regular cadaveric dissection in the Department of Anatomy at AIIMS, Bhubaneswar, a case of right sided absence of sternohyoid muscle with left sided tendinous superior belly of omohyoid muscle was found. Though literature survey shows the tendinous belly (or absence) of superior belly of omohyoid muscle, but its presence in combination with absence of opposite side sternohyoid muscle is hardly reported. The omohyoid muscle has effect on intracerebral venous hemodynamics. Developing from a common muscle primodium the infrahyoid muscle group shows a number of variations. Because of increased use of Infrahyoid myocutaneous flaps for medium sized head and neck reconstruction surgery this knowledge will be helpful for handling and selecting a flap.

Variant Omohyoid Muscle: Report of Two Cases.

Omohyoid muscle consists of superior and inferior bellies connected by an intermediate tendon. Various anomalies of superior belly of omohyoid are described in literature. However, absence of superior belly of omohyoid is rarely reported. During regular head and neck dissection conducted for dental students at M S Ramaiah Medical College, variant omohyoid muscle were found in two male cadavers of south Indian origin. The variation noticed was unilateral in both the cases with normal inferior belly of omohyoid. In these cases the absent superior belly of omohyoid, is replaced by a fibrous tendon. Surgeons should be aware of this variation as it forms an important landmark for head and neck surgeries. It is also used as myocutaneous flaps for various reconstruction procedures.

Unusual morphology of the superior belly of omohyoid muscle / 대한해부학회지

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.

Variation of the Infrahyoid Muscle: Duplicated Omohyoid and Appearance of the Levator Glandulae Thyroideae Muscles

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.

Omohyoid Muscle Syndrome / 대한이비인후과학회지

BACKGROUND: Some patients present transient swelling on lower lateral neck during swallowing; this condition is known as "omohyoid syndrome" or "omohyoid sling syndrome". The purpose of this case report is to evaluate the proper mechanism as well as to give the reader an appreciation for the proper diagnosis and treatment to this not-uncommon condition. METHODS: There were three cases between May, 2000 and January, 2001. The photography, real-time sonography, and computed tomography (CT) were used. RESULTS: There was a brief report on omohyoid syndrome. The sternocleidomastoid muscle is passively tented up by an underlying omohyoid muscle, and the omohyoid muscle is paradoxically thickened during swallowing. The former appears to have lost its restriction to bowstring by the retaining deep cervical fascia. And the latter seems to result from lack of its relaxation during laryngeal elevation. CONCLUSION: The described approaches allow for precise diagnosis and definite proof of the pathogenetic mechanism.

Ansa cervicalis and herve to superior belly of omohyoid.

Eighty Cardavers were studied. The mean kength of nerve to superior belly of omohyoid was 4.37 cm., with the range varying from 1.39 to 8.26 cm. There was no trouble swinging part of superior belly of Omohyoid together with its nerve, to posterior surface of posterior cricoarytenoid. The pattern of a nsa cervicalis varied in many difference types not as simple as described in standard textbooks.