Biomaterials such as bone,teeth,nacre and silk are known to have superior mechanical properties due to their specific nanocomposite structures.Here we report that the woodpecker's tongue exhibits a novel strength ...Biomaterials such as bone,teeth,nacre and silk are known to have superior mechanical properties due to their specific nanocomposite structures.Here we report that the woodpecker's tongue exhibits a novel strength and flexibility due to its special composite micro/nanostructure.The tongue consists of a flexible cartilage-and-bone skeleton covered with a thin layer tissue of high strength and elasticity.At the interface between the cartilage-and-bone skeleton and the tissue layer,there is a hierarchical fiber-typed connection.It is this special design of the tongue that makes the woodpeckers efficient in catching the insects inside trees.The special micro/nanostructures of the woodpecker's tongue show us a potential method to enhance the interfacial connection between soft and hard material layers for bio-inspired composite system designs.展开更多
BACKGROUND Metastasis to the hyoid bone is an exceptionally rare occurrence,with documented cases limited to breast,liver,colon,skin,lung,and prostate cancers.This report highlights an unusual case involving the metas...BACKGROUND Metastasis to the hyoid bone is an exceptionally rare occurrence,with documented cases limited to breast,liver,colon,skin,lung,and prostate cancers.This report highlights an unusual case involving the metastasis of lung adenocarcinoma to the hyoid bone,accompanied by a distinctive headache.Previous documentation involved surgical resection of the hyoid mass.We present a case displaying the benefits of palliative radiotherapy.CASE SUMMARY A 72-year-old non-smoking,non-alcoholic woman,initially under investigation for a year-long elevation in absolute lymphocyte count,presented with a monthlong history of intermittent throat pain.Despite negative findings in gastroenterological and otolaryngologic examinations,a contrast-enhanced chest computed tomography scan revealed a mediastinal mass and questionable soft tissue thickening in her left anterolateral neck.Subsequent imaging and biopsies confirmed the presence of lung adenocarcinoma metastasis to the hyoid bone.The patient was treated with platinum-based chemo-immunotherapy along with pembrolizumab.Ultimately,the lung cancer was unresponsive.Our patient opted for palliative radiation therapy instead of surgical resection to address her throat pain.As a result,her throat pain was alleviated,and it also incidentally resolved her chronic headaches.This is the second documented case of lung adenocarcinoma metastasizing to the hyoid bone.CONCLUSION Palliative radiotherapy may add to the quality of life in symptomatic patients with cancer metastatic to the hyoid bone.展开更多
Objective:Determine if anatomic dimensions of airway structures are associated with airway obstruction in obstructive sleep apnea (OSA) patients.Methods:Twenty-eight subjects with (n =14) and without (n =14) OSA as de...Objective:Determine if anatomic dimensions of airway structures are associated with airway obstruction in obstructive sleep apnea (OSA) patients.Methods:Twenty-eight subjects with (n =14) and without (n =14) OSA as determined by clinical symptoms and sleep studies;volunteer sample.Skeletal and soft tissue dimensions were measured from radiocephalometry and magnetic resonance imaging.The soft palate thickness,mandibular plane-hyoid (MP-H) distance,posterior airway space (PAS) diameters and area,and tongue volume were calculated.Results:Compared to controls,the OSA group demonstrated a significantly longer MP-H distance (P =0.009) and shorter nasal PAS diameter (P =0.02).The PAS area was smaller (P =0.002) and tongue volume larger in the OSA group (P =0.004).The MP-H distance,PAS measurements,and tongue volume are of clinical relevance in OSA patients.Conclusions:A long MP-H distance,and small PAS diameters and area are significant anatomic measures in OSA;however the most substantial parameter found was a large tongue volume.展开更多
Objective:Determine the effects of hyoid myotomy and suspension (HMS) without concurrent palatal or tongue base sleep surgery for obstructive sleep apnea (OSA).Method:Patients with OSA treated with HMS were identified...Objective:Determine the effects of hyoid myotomy and suspension (HMS) without concurrent palatal or tongue base sleep surgery for obstructive sleep apnea (OSA).Method:Patients with OSA treated with HMS were identified using CPT code (21685) at an academic and private sleep surgery clinic.Those who underwent concurrent palatal or tongue base sleep surgery were excluded.Outcomes included simultaneous procedures,apnea-hypopnea index (AHI),lowest oxyhemoglobin saturation (LSAT),and Epworth Sleepiness Scale (ESS).Results:Nineteen patients with OSA underwent HMS without palatal or tongue base sleep surgery.The average age at surgery was (55.3 ± 13.5) years with a majority of patients being male (71％).Concurrent procedures included the following:torus mandibularis excision (n =1),endoscopic sinus surgery (n =4),septoplasty (n =10),inferior turbinate reduction (n =12),and nasal valve repair (n =2).AHI improved signiflcantly from (39.7 ± 21.2) eventslh to (22.6 ± 22.7) events/h after HMS (P ＜ 0.01),which represented a 43％ reduction.LSAT significantly increased from (82.2％ ± 9.9％) to (86.6％ ± 6.2％),P ＜ 0.01.There was no improvement in ESS after surgery (8.2 ± 4.4) to (8.3 ± 5.2),P =0.904.A subset of patients with severe OSA (AHI ＞ 30 events/h) had an improvement in AHI from (49.9 ± 16.6) events/h to (29.1 ± 24.9) events/h,P ＜ 0.01.Conclusion:HMS without palatal or tongue base sleep surgery improves OSA severity.It can be considered as a valid option in the treatment of OSA in appropriately-selected patients.展开更多
Objective: Laryngeal reconstruction is needed to preserve laryngeal function in patients who have undergone extensive vertical or frontal partial laryngectomy. However, the procedure remains a difficult challenge. Sev...Objective: Laryngeal reconstruction is needed to preserve laryngeal function in patients who have undergone extensive vertical or frontal partial laryngectomy. However, the procedure remains a difficult challenge. Several reconstruction techniques have been described, but these techniques pose risks of complications such as laryngeal stenosis. This study aimed to evaluate the postoperative course and functional outcomes of a new technique that combined a muscle-pedicle hyoid bone and a thyrohyoid flap during laryngeal reconstruction after tumor resection. Methods: Four patients underwent extensive vertical partial or frontal partial laryngectomy for cancer. After tumor resection, laryngeal reconstruction was performed using the proposed technique. Postoperative recovery time, complications, and oncologic results were evaluated. Results: The four patients were successfully treated with the proposed technique. No dyspnea, dysphagia, or death occurred during the postoperative course. Decannulation was performed after a median of 3 days. The average postoperative hospital stay was 7 days. Short-term postoperative functional recovery was normal. No laryngeal stenosis or tumor recurrence was observed in any of the four patients after a follow-up period of more than 24 months. Conclusion: The combination of the muscle-pedicle hyoid bone and the thyrohyoid flap is a reliable procedure for laryngeal reconstruction after extensive vertical partial or frontal partial laryngectomy.展开更多
<b><span style="font-family:Verdana;">Objectives: </span></b></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><spa...<b><span style="font-family:Verdana;">Objectives: </span></b></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">T</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">he </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">objective</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> is to</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> determine whether there are differences in the position of the hyoid bone at rest in natural head position in subjects with mandibular hyperdivergence</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> and </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">to evaluate whether there are differences in hyoid position and antegonial notch depth in mandibular hyperdivergent males and females. </span><b><span style="font-family:Verdana;">Methods and Materials: </span></b><span style="font-family:Verdana;">This is a retrospective cohort study involving a review of lateral cephalometric radiographs of 45 adult men and women with mandibular hyperdivergency. Hyperdivergency was determined by cephalometric ranges of: SN-GoGn as least +2 SD from normal, Y-axis, PP-GoGN, and gonial angle greater than +1SD from normal. A group of 45 normodivergent adults served as a control, with cephalometric ranges of: SN-GoGn within </span></span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">±</span><span><span style="font-family:Verdana;">1 SD of normal, with only one measurement of the other three between +1 and +1.5 standard deviations. A custom digital cephalometric analysis, the Hyoid Analy展开更多
Purpose: Swallowing function was in a patient with tongue cancer that was evaluated with video fluorography before and after subtotal glossectomy and reconstruction with a rectus abdominis muscuocutaneous flap. Materi...Purpose: Swallowing function was in a patient with tongue cancer that was evaluated with video fluorography before and after subtotal glossectomy and reconstruction with a rectus abdominis muscuocutaneous flap. Materials and Methods: A 41-year-old man underwent subtotal glossectomy and retained the unilateral posterior mylohyoid and unilateral stylohyoid muscles. The structure of the flap was evaluated postoperatively. To assess swallowing function, video fluorography was performed before surgery, 1 month after surgery and 1 year after surgery. Testing involved 1) ability to hold 10 mL of liquid in the oral cavity, 2) epiglottis turnover, 3) the presence of aspiration, 4) hyoid bone movement, and 5) maximum width of the esophageal entrance. Results: The flap was protuberant postoperatively. The patient was able to hold the test diet in the oral cavity before and after surgery. Epiglottis turnover was good before surgery but insufficient after surgery. Aspiration during swallowing was not observed before or after surgery. At rest, the hyoid bone sagged postoperatively, in comparison with preoperatively. Hyoid bone movement and width of the esophageal entrance decreased after surgery;however, they demonstrated gradual recovery. Conclusions: For good postoperative swallowing function after subtotal glossectomy, it is necessary to perform reconstruction with protuberant flap and to retain the suprahyoid muscles as much as possible.展开更多
基金supported by the National Natural Science Foundation of China (Projects Nos. 10672035,10802019,10721062 and 90816025).
文摘Biomaterials such as bone,teeth,nacre and silk are known to have superior mechanical properties due to their specific nanocomposite structures.Here we report that the woodpecker's tongue exhibits a novel strength and flexibility due to its special composite micro/nanostructure.The tongue consists of a flexible cartilage-and-bone skeleton covered with a thin layer tissue of high strength and elasticity.At the interface between the cartilage-and-bone skeleton and the tissue layer,there is a hierarchical fiber-typed connection.It is this special design of the tongue that makes the woodpeckers efficient in catching the insects inside trees.The special micro/nanostructures of the woodpecker's tongue show us a potential method to enhance the interfacial connection between soft and hard material layers for bio-inspired composite system designs.
文摘BACKGROUND Metastasis to the hyoid bone is an exceptionally rare occurrence,with documented cases limited to breast,liver,colon,skin,lung,and prostate cancers.This report highlights an unusual case involving the metastasis of lung adenocarcinoma to the hyoid bone,accompanied by a distinctive headache.Previous documentation involved surgical resection of the hyoid mass.We present a case displaying the benefits of palliative radiotherapy.CASE SUMMARY A 72-year-old non-smoking,non-alcoholic woman,initially under investigation for a year-long elevation in absolute lymphocyte count,presented with a monthlong history of intermittent throat pain.Despite negative findings in gastroenterological and otolaryngologic examinations,a contrast-enhanced chest computed tomography scan revealed a mediastinal mass and questionable soft tissue thickening in her left anterolateral neck.Subsequent imaging and biopsies confirmed the presence of lung adenocarcinoma metastasis to the hyoid bone.The patient was treated with platinum-based chemo-immunotherapy along with pembrolizumab.Ultimately,the lung cancer was unresponsive.Our patient opted for palliative radiation therapy instead of surgical resection to address her throat pain.As a result,her throat pain was alleviated,and it also incidentally resolved her chronic headaches.This is the second documented case of lung adenocarcinoma metastasizing to the hyoid bone.CONCLUSION Palliative radiotherapy may add to the quality of life in symptomatic patients with cancer metastatic to the hyoid bone.
文摘Objective:Determine if anatomic dimensions of airway structures are associated with airway obstruction in obstructive sleep apnea (OSA) patients.Methods:Twenty-eight subjects with (n =14) and without (n =14) OSA as determined by clinical symptoms and sleep studies;volunteer sample.Skeletal and soft tissue dimensions were measured from radiocephalometry and magnetic resonance imaging.The soft palate thickness,mandibular plane-hyoid (MP-H) distance,posterior airway space (PAS) diameters and area,and tongue volume were calculated.Results:Compared to controls,the OSA group demonstrated a significantly longer MP-H distance (P =0.009) and shorter nasal PAS diameter (P =0.02).The PAS area was smaller (P =0.002) and tongue volume larger in the OSA group (P =0.004).The MP-H distance,PAS measurements,and tongue volume are of clinical relevance in OSA patients.Conclusions:A long MP-H distance,and small PAS diameters and area are significant anatomic measures in OSA;however the most substantial parameter found was a large tongue volume.
文摘Objective:Determine the effects of hyoid myotomy and suspension (HMS) without concurrent palatal or tongue base sleep surgery for obstructive sleep apnea (OSA).Method:Patients with OSA treated with HMS were identified using CPT code (21685) at an academic and private sleep surgery clinic.Those who underwent concurrent palatal or tongue base sleep surgery were excluded.Outcomes included simultaneous procedures,apnea-hypopnea index (AHI),lowest oxyhemoglobin saturation (LSAT),and Epworth Sleepiness Scale (ESS).Results:Nineteen patients with OSA underwent HMS without palatal or tongue base sleep surgery.The average age at surgery was (55.3 ± 13.5) years with a majority of patients being male (71％).Concurrent procedures included the following:torus mandibularis excision (n =1),endoscopic sinus surgery (n =4),septoplasty (n =10),inferior turbinate reduction (n =12),and nasal valve repair (n =2).AHI improved signiflcantly from (39.7 ± 21.2) eventslh to (22.6 ± 22.7) events/h after HMS (P ＜ 0.01),which represented a 43％ reduction.LSAT significantly increased from (82.2％ ± 9.9％) to (86.6％ ± 6.2％),P ＜ 0.01.There was no improvement in ESS after surgery (8.2 ± 4.4) to (8.3 ± 5.2),P =0.904.A subset of patients with severe OSA (AHI ＞ 30 events/h) had an improvement in AHI from (49.9 ± 16.6) events/h to (29.1 ± 24.9) events/h,P ＜ 0.01.Conclusion:HMS without palatal or tongue base sleep surgery improves OSA severity.It can be considered as a valid option in the treatment of OSA in appropriately-selected patients.
基金supported by the Natural Science Foundation of Guangdong Province, China (Grant No. 303041353002)
文摘Objective: Laryngeal reconstruction is needed to preserve laryngeal function in patients who have undergone extensive vertical or frontal partial laryngectomy. However, the procedure remains a difficult challenge. Several reconstruction techniques have been described, but these techniques pose risks of complications such as laryngeal stenosis. This study aimed to evaluate the postoperative course and functional outcomes of a new technique that combined a muscle-pedicle hyoid bone and a thyrohyoid flap during laryngeal reconstruction after tumor resection. Methods: Four patients underwent extensive vertical partial or frontal partial laryngectomy for cancer. After tumor resection, laryngeal reconstruction was performed using the proposed technique. Postoperative recovery time, complications, and oncologic results were evaluated. Results: The four patients were successfully treated with the proposed technique. No dyspnea, dysphagia, or death occurred during the postoperative course. Decannulation was performed after a median of 3 days. The average postoperative hospital stay was 7 days. Short-term postoperative functional recovery was normal. No laryngeal stenosis or tumor recurrence was observed in any of the four patients after a follow-up period of more than 24 months. Conclusion: The combination of the muscle-pedicle hyoid bone and the thyrohyoid flap is a reliable procedure for laryngeal reconstruction after extensive vertical partial or frontal partial laryngectomy.
文摘<b><span style="font-family:Verdana;">Objectives: </span></b></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">T</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">he </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">objective</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> is to</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> determine whether there are differences in the position of the hyoid bone at rest in natural head position in subjects with mandibular hyperdivergence</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> and </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">to evaluate whether there are differences in hyoid position and antegonial notch depth in mandibular hyperdivergent males and females. </span><b><span style="font-family:Verdana;">Methods and Materials: </span></b><span style="font-family:Verdana;">This is a retrospective cohort study involving a review of lateral cephalometric radiographs of 45 adult men and women with mandibular hyperdivergency. Hyperdivergency was determined by cephalometric ranges of: SN-GoGn as least +2 SD from normal, Y-axis, PP-GoGN, and gonial angle greater than +1SD from normal. A group of 45 normodivergent adults served as a control, with cephalometric ranges of: SN-GoGn within </span></span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">±</span><span><span style="font-family:Verdana;">1 SD of normal, with only one measurement of the other three between +1 and +1.5 standard deviations. A custom digital cephalometric analysis, the Hyoid Analy
文摘Purpose: Swallowing function was in a patient with tongue cancer that was evaluated with video fluorography before and after subtotal glossectomy and reconstruction with a rectus abdominis muscuocutaneous flap. Materials and Methods: A 41-year-old man underwent subtotal glossectomy and retained the unilateral posterior mylohyoid and unilateral stylohyoid muscles. The structure of the flap was evaluated postoperatively. To assess swallowing function, video fluorography was performed before surgery, 1 month after surgery and 1 year after surgery. Testing involved 1) ability to hold 10 mL of liquid in the oral cavity, 2) epiglottis turnover, 3) the presence of aspiration, 4) hyoid bone movement, and 5) maximum width of the esophageal entrance. Results: The flap was protuberant postoperatively. The patient was able to hold the test diet in the oral cavity before and after surgery. Epiglottis turnover was good before surgery but insufficient after surgery. Aspiration during swallowing was not observed before or after surgery. At rest, the hyoid bone sagged postoperatively, in comparison with preoperatively. Hyoid bone movement and width of the esophageal entrance decreased after surgery;however, they demonstrated gradual recovery. Conclusions: For good postoperative swallowing function after subtotal glossectomy, it is necessary to perform reconstruction with protuberant flap and to retain the suprahyoid muscles as much as possible.
