Dysphagia in a Patient with Asymmetric Elevation of the Hyoid Bone
Dysphagia in a Patient with Asymmetric Elevation of the Hyoid Bone
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DOI：
10.1007/s00455-020-10196-x
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发表时间：
2020-11-10
期刊：
影响因子：
2.6
通讯作者：
Kariya, Shin
中科院分区：
文献类型：
--
作者：
Uraguchi, Kensuke;Makihara, Seiichiro;Kariya, Shin
茎突起源于颞骨，茎突舌骨肌和韧带起源于茎突，插入舌骨的小角。Eagle综合征是一种茎突相关疾病，以吞咽困难、颈部异物感、颈部和颅面疼痛为特征。茎突的延长可能是由于茎突舌骨韧带的完全钙化，这有时会阻止舌骨的上升，导致吞咽困难。茎突舌骨复合体综合征是茎突舌骨器官变异的一种类型，它包括茎突拉长、茎突舌骨韧带骨化和舌骨团拉长。所有这些连接可导致舌骨张力、膨胀性降低和舌骨抬升受限。通过手术干预来破坏这种复合体可以通过缩短茎突来缓解紧张并改善患者的症状。对于手术，选择两种传统手术入路之一：经口入路或经颈入路。虽然经口入路更容易，但经颈入路是骨化茎突舌骨韧带的标准入路。吞咽困难患者的茎突与吞咽疼痛的关系应予以考虑。
DiscussionThe styloid process arises from the temporal bone, and the stylohyoid muscle and ligament originate at the styloid process, inserting on the lesser cornu of the hyoid bone. Eagle syndrome is well known as a styloid process-associated disease characterized by dysphagia, a foreign body sensation in the neck, and cervical and craniofacial pain [1]. The elongated styloid process may be due to the complete calcification of the stylohyoid ligament, which sometimes prevents hyoid elevation and leads to dysphagia [2]. Stylohyoid complex syndrome is one of the classifications of stylohyoid apparatus variations, and it includes an elongated styloid process, ossified stylohyoid ligament, and elongated hyoid bone [3]. All of these connections can result in tension, reduced distensibility, and restricted movement of hyoid elevation. The treatment by surgical intervention to disrupt this complex can relieve tension and improve the patient’s symptoms by shortening the styloid process. For the surgery, one of the two traditional surgical approaches is selected: the transoral approach or transcervical approach. Although the transoral approach is easier, the transcervical approach is standard for an ossified stylohyoid ligament. The connection of the styloid process in patients with dysphasia and swallowing pain should be taken into consideration.