Positional change of hyoid bone after anesthesia in anterior surgery of upper cervical spine

Lim, Jong-Han; Wang, Seong-Il; Kim, Do-Yeon; Song, Kyung-Jin; Kim, Tae Kyun; Lee, Kwang-Bok

doi:10.1016/j.spinee.2013.10.039

Cited by 3 publications

(1 citation statement)

References 5 publications

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“…Dependency of the longitudinal hyoid bone displacement on severity of OSA found in this study has never been documented in the literature. Interestingly, Lim et al, orthopedic surgeons, recently alerted the use of the hyoid bone position as a surgical landmark for the C3 cervical level because of variable and significant hyoid bone displacement by induction of general anesthesia and paralysis [31]. They found no significant association between the degree of the hyoid bone displacement and gender, obesity, and age.…”

Section: Discussionmentioning

confidence: 99%

Displacement of the hyoid bone by muscle paralysis and lung volume increase: the effects of obesity and obstructive sleep apnea

Kohno

Kitamura

Kato

et al. 2018

Sleep

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Study ObjectivesAnimal studies suggest a pivotal role of the hyoid bone in obstructive sleep apnea (OSA). We aimed to explore the role of the hyoid bone in humans by testing the hypotheses that muscle paralysis and lung volume (LV) changes displace the hyoid bone position particularly in people with obesity and/or OSA.MethodsFifty patients undergoing general anesthesia participated in this study (20 participants with nonobese, non-OSA; 8 people with nonobese OSA; and 22 people with obese OSA). Three lateral neck radiographs to assess the hyoid position (primary variable) and craniofacial structures were taken during wakefulness, complete muscle paralysis under general anesthesia, and LV increase under general anesthesia. LV was increased by negative extrathoracic pressure application and LV changes were measured with a spirometer. Analysis of covariance was used to identify statistical significance.ResultsMuscle paralysis under general anesthesia significantly displaced the hyoid bone posteriorly (95% CI: 1.7 to 4.6, 1.5 to 5.2, and 1.1 to 4.0 mm in nonobese non-OSA, nonobese OSA, and obese OSA groups, respectively), and this was more prominent in people with central obesity. LV increase significantly displaced the hyoid bone caudally in all groups (95% CI: 0.2 to 0.7, 0.02 to 0.6, and 0.2 to 0.6 mm/0.1 liter LV increase in nonobese non-OSA, nonobese OSA, and obese OSA groups, respectively). Waist–hip ratio was directly associated with the caudal displacement during LV increase.ConclusionsThe hyoid bone plays an important role in the pathophysiology of pharyngeal airway obstruction due to muscle paralysis and LV reduction, particularly in people with obesity.Clinical TrialUMIN Clinical Trial Registry, https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=cR000022635&language=E, UMIN000019578

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Section: Discussionmentioning

confidence: 99%

Displacement of the hyoid bone by muscle paralysis and lung volume increase: the effects of obesity and obstructive sleep apnea

Kohno

Kitamura

Kato

et al. 2018

Sleep

View full text Add to dashboard Cite

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Radiographic Evaluation of the Reliability of Neck Anatomic Structures as Anterior Cervical Surgical Landmarks

Liu

Xiong

et al. 2017

World Neurosurgery

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Hypoglossal Nerve Palsy After Anterior Cervical Spine Surgery

Colón

Isaza

Katsuura

et al. 2020

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Case: A 37-year-old man was found to have hypoglossal nerve palsy after undergoing anterior cervical spine surgery at C3-C5, an injury that would cause him severe disability and further complications. Conclusion: Knowledge of the hypoglossal nerve is crucial for cervical spine surgery even at lower levels (C4-C7), including variations in its course and potential displacement during the induction of anesthesia.

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Positional change of hyoid bone after anesthesia in anterior surgery of upper cervical spine

Cited by 3 publications

References 5 publications

Displacement of the hyoid bone by muscle paralysis and lung volume increase: the effects of obesity and obstructive sleep apnea

Displacement of the hyoid bone by muscle paralysis and lung volume increase: the effects of obesity and obstructive sleep apnea

Radiographic Evaluation of the Reliability of Neck Anatomic Structures as Anterior Cervical Surgical Landmarks

Hypoglossal Nerve Palsy After Anterior Cervical Spine Surgery

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