The Experts below are selected from a list of 186 Experts worldwide ranked by ideXlab platform
John Maddalozzo - One of the best experts on this subject based on the ideXlab platform.
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posterior hyoid space as related to excision of the thyroglossal duct cyst
Laryngoscope, 2010Co-Authors: John Maddalozzo, Jeremy Alderfer, Vikash K ModiAbstract:Objectives/Hypothesis: The anatomy of the anterior neck in the area of the hyoid, Thyrohyoid Membrane, and epiglottis is herein redescribed and compared to its classical depiction. The concept of the posterior hyoid space (PHS) is defined and substantiated through review of archived tissue and cadaver larynx dissection as well as by observation at many surgical dissections. The true anatomy of these relationships provides an insight into the effectiveness of the Sistrunk procedure. The author believes that recurrence of thyroglossal duct cysts (TGDC) occurs as a consequence of incomplete resection of: 1) microscopic suprahyoid ductules and/or 2) infra- and perihyoid tissue. Study Design: The senior author has been using the concept of the posterior hyoid space as applied to the Sistrunk procedure for more than 20 years. A retrospective study was done on cases from April 2003 to August 2008, and outcome was reviewed and compared to historical controls to determine the impact of applying this anatomic concept. Methods: A retrospective chart review was undertaken on 60 surgical cases performed for a 5-year period with clinical follow-up extended to an additional 7 months. Data collected included age at surgery, presenting symptoms, imaging characteristics, thyroid status, pathology results, and postoperative complications. All 60 were under the age of 18 who underwent a modified Sistrunk procedure and had a postoperative diagnosis of TGDC. Each patient had a minimum follow-up period of 4 months to check for recurrences. No revision was included in this study. Results: Sixty patients met criteria for the study. There was one recurrence (1.67%); a complication rate of 6.67%. Complications were minor and wound related. Mean follow-up was 17 months. Conclusions: The technique of applying the concept of a PHS to ensure the complete resection of the middle third of the hyoid bone and offending tissues is believed to decrease recurrence of TGDC secondary to incomplete resection in the perihyoid area. Laryngoscope, 2010
Vikash K Modi - One of the best experts on this subject based on the ideXlab platform.
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posterior hyoid space as related to excision of the thyroglossal duct cyst
Laryngoscope, 2010Co-Authors: John Maddalozzo, Jeremy Alderfer, Vikash K ModiAbstract:Objectives/Hypothesis: The anatomy of the anterior neck in the area of the hyoid, Thyrohyoid Membrane, and epiglottis is herein redescribed and compared to its classical depiction. The concept of the posterior hyoid space (PHS) is defined and substantiated through review of archived tissue and cadaver larynx dissection as well as by observation at many surgical dissections. The true anatomy of these relationships provides an insight into the effectiveness of the Sistrunk procedure. The author believes that recurrence of thyroglossal duct cysts (TGDC) occurs as a consequence of incomplete resection of: 1) microscopic suprahyoid ductules and/or 2) infra- and perihyoid tissue. Study Design: The senior author has been using the concept of the posterior hyoid space as applied to the Sistrunk procedure for more than 20 years. A retrospective study was done on cases from April 2003 to August 2008, and outcome was reviewed and compared to historical controls to determine the impact of applying this anatomic concept. Methods: A retrospective chart review was undertaken on 60 surgical cases performed for a 5-year period with clinical follow-up extended to an additional 7 months. Data collected included age at surgery, presenting symptoms, imaging characteristics, thyroid status, pathology results, and postoperative complications. All 60 were under the age of 18 who underwent a modified Sistrunk procedure and had a postoperative diagnosis of TGDC. Each patient had a minimum follow-up period of 4 months to check for recurrences. No revision was included in this study. Results: Sixty patients met criteria for the study. There was one recurrence (1.67%); a complication rate of 6.67%. Complications were minor and wound related. Mean follow-up was 17 months. Conclusions: The technique of applying the concept of a PHS to ensure the complete resection of the middle third of the hyoid bone and offending tissues is believed to decrease recurrence of TGDC secondary to incomplete resection in the perihyoid area. Laryngoscope, 2010
Yonca Anik - One of the best experts on this subject based on the ideXlab platform.
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superior laryngeal neuralgia after acute laryngitis and treatment with a single injection of a local anesthetic
Archives of Otolaryngology-head & Neck Surgery, 2007Co-Authors: Omer Aydin, Murat Ozturk, Yonca AnikAbstract:Superior laryngeal neuralgia is described as a rare disorder characterized by severe pain in the lateral aspect of the throat, submandibular region, and underneath the ear, pre-cipitated by swallowing, shouting, or turning the head. A trigger point is present on the lateral aspect of the throat overlying the Thyrohyoid Membrane. The etiology of superior laryngeal neuralgia is unclear, although infections may precipitate this disease.
Julio C Furlan - One of the best experts on this subject based on the ideXlab platform.
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surgical anatomy of the extralaryngeal aspect of the superior laryngeal nerve
Archives of Otolaryngology-head & Neck Surgery, 2003Co-Authors: Julio C Furlan, Lenine Garcia Brandao, Alberto Rossetti Ferraz, Aldo Junqueira RodriguesAbstract:Objectives To describe the topography of the superior laryngeal nerve (SLN) and to evaluate the influence of gender, ethnicity, side of the neck, and individual height on the topography of the SLN. Design Anatomical study of human cadavers. Subjects Fifty fresh human cadavers (19 female subjects and 31 male subjects; age range, 22-89 years; mean age, 61 years) were randomly selected for this study. The subjects were divided into nonwhite (n = 18) and white (n = 32) ethnic groups. The t test and linear regression were used for statistical analysis of data. Results All SLNs emerged medially to the vagus nerve. The SLNs mostly divided into internal (ibSLN) and external (ebSLN) branches distally from their origin (94%). The mean ± SE length of the SLN trunk was 16.7 ± 0.9 mm and was affected by gender ( P = .01) but not ethnicity ( P = .57), side of the neck ( P = .96), or individual height ( R 2 = 0.01; P = .33). The length of the ibSLN reached 44.9 ± 1.0 mm and was unaffected by gender ( P = .91), ethnicity ( P = .24), side ( P = .40), or height ( R 2 P = .71). The length of the ebSLN measured 62.6 ± 1.2 mm and was unaffected by gender ( P = .69), ethnicity ( P = .42), side ( P = .26), or height ( R 2 P = .85). The mean ± SE angle between the ibSLN and the tracheoesophageal sulcus was 49° ± 1° and was unaffected by gender ( P = .35), ethnicity ( P = .11), side ( P = .26), or height ( R 2 P = .96). Only 1 subject demonstrated a bilateral anatomical variation of the ibSLN close to its entrance into the Thyrohyoid Membrane. Conclusions The topography of the SLN has a few anatomical variations and is unaffected by gender, ethnicity, side of the neck, and individual height, except that the SLN is longer in males than in females. These findings are important in that they can help in the prevention of SLN injuries during operations such as laryngectomy and neck dissection, as well as in the planning of laryngeal reinnervation and transplantation.
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anatomical study applied to anesthetic block technique of the superior laryngeal nerve
Acta Anaesthesiologica Scandinavica, 2002Co-Authors: Julio C FurlanAbstract:Background: The topography of the internal branch of the superior laryngeal nerve (ibSLN) was prospectively studied to evaluate the greater horn of the hyoid bone (ghHB) and the incisura of the thyroid cartilage (iTC) as anatomical repairs in laryngeal anesthetic block. Factors such as gender, ethnicity and side of the neck were also analyzed concerning their influence in the ibSLN position. Methods: One hundred neck dissections were performed in 50 human cadavers bilaterally identifying the ibSLN, the ghHB and iTC. The distance between the ghHB and ibSLN in the cranio-caudal direction (dHB), and the distance between the iTC and the ipsilateral Thyrohyoid Membrane ostium (dTC) were measured. Furthermore, the results were statistically analyzed according to ethnicity, gender and side of the neck. Results: The ibSLN was juxtaposed to the apex ghBH in 31 out of 100 dissections. The mean dHB was 2.4 mm, and mean dTC was 33.4 mm. The statistical analysis did not identify any significant difference regarding those distances between the groups in terms of ethnicity, gender and side of the neck. Conclusion: The ibSLN was often dissected very close to the ghHB, and this result was not influenced by any factor studied. Therefore, the ghHB can be considered a good anatomical repair to localize the ibSLN in the local block of the larynx. Furthermore, the dTC could frequently be reached by routinely used nerve block needle. However, a few anatomical variations may occur, resulting in a low failure rate of this anesthetic procedure.
Deepak Awasthi - One of the best experts on this subject based on the ideXlab platform.
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anatomic considerations of superior laryngeal nerve during anterior cervical spine procedures
Spine, 2002Co-Authors: Hooman Melamed, Mitchel B. Harris, Deepak AwasthiAbstract:STUDY DESIGN Cadavers were dissected anatomically to identify the course of the superior laryngeal nerve relative to the spinal column. OBJECTIVE To illustrate the anatomic relation of the SLN with respect to its vulnerability during anterior cervical spine procedures. SUMMARY OF BACKGROUND DATA There is ample literature referencing the superior laryngeal nerve with respect to head and neck surgery. Detailed descriptions of the anatomy of the recurrent laryngeal nerve are quite extensive in both the spine and head and neck literature. To the authors' best knowledge, no similar reports have delineated the anatomic relation of the superior laryngeal nerve in procedures on the anterior aspect of the cervical spine. METHODS Ten dissections were carried out on human cadavers to show the course of the superior laryngeal nerve. Particular attention was directed to the internal branch of the superior laryngeal nerve to show the overall anatomic relation relative to standard landmarks. These landmarks included the superior laryngeal and superior thyroid arteries, the split of the superior laryngeal nerve, and the intervertebral disc space. RESULTS The superior laryngeal nerve originates from the vagus nerve in the carotid sheath and bifurcates into internal and external branches. Distally, the internal branch of the superior laryngeal nerve courses in close proximity with the superior laryngeal artery and inserts within 1 cm superior to the superior laryngeal artery into the Thyrohyoid Membrane. With respect to the cervical spine, the distal of portion of the internal branch of the superior laryngeal nerve is located between the C3 and C4 vertebral bodies. CONCLUSIONS The internal branch of the superior laryngeal nerve supplies innervation to the mucosa of the larynx and has an important sensory reflex that serves to protect the lungs from aspiration. Injury to this nerve can predispose the patient to life-threatening pneumonia. It is therefore imperative for the surgeon to recognize the location and course of this nerve to avoid injuring it. Injury most commonly occurs either by excessive retraction in different planes or by accidental ligation of the nerve.