Hyoid Bone

舌骨
  • 文章类型: Journal Article
    目的:本研究旨在探讨舌骨(HB)和咽气道间隙(PAS)的三维(3D)测量与矢状和垂直错牙合的关系。
    方法:总共368次锥束计算机断层扫描(CBCT)扫描分为三个骨骼组(I类,II,和III)并按垂直增长模式细分(差异较大,normodivergent,和高度发散)。PAS尺寸,包括鼻咽,口咽,下咽,和总气道空间,以表面积测量,volume,最小收缩面积(MCA),长度,和宽度,使用InVivo6.0.3和Dolphin11.8软件在3D中分析HB位置和尺寸。数据采用双向方差分析,和Bonferroni事后测试,P≤0.05被认为是显著的。
    结果:研究发现,骨骼III类且生长方式不足的患者舌骨的矢状位置最高,而骨骼II类和超发散型的舌骨长度最低。骨性III类患者的鼻咽气道间隙宽度明显较低,而过度发散患者的体积和面积较低。口咽和下咽尺寸也受到骨骼类别和生长模式的影响,过度发散患者的价值最低。咽部总容积,area,最小收缩区域也受到影响,其中过度发散患者的值最低,骨骼II类患者的最小收缩面积最低。
    结论:咽部气道尺寸和舌骨参数随错牙合而变化。舌骨的位置影响气道,确定有气道阻塞和睡眠呼吸紊乱风险的患者。
    OBJECTIVE: This study aimed to explore the relationship between three-dimensional (3D) measurements of the hyoid bone (HB) and pharyngeal airway space (PAS) in relation to sagittal and vertical malocclusion.
    METHODS: A total of 368 cone-beam computed tomography (CBCT) scans were classified into three skeletal groups (Class I, II, and III) and subdivided by vertical growth patterns (hypodivergent, normodivergent, and hyperdivergent). PAS dimensions, including nasopharyngeal, oropharyngeal, hypopharyngeal, and total airway spaces, were measured in surface area, volume, minimum constricted area (MCA), length, and width, HB position and dimension were analyzed in 3D using InVivo 6.0.3 and Dolphin 11.8 software. Data were analyzed using two-way ANOVA, and Bonferroni post-hoc tests, with P ≤ 0.05 considered significant.
    RESULTS: The study found that patients with skeletal Class III and hypodivergent growth pattern had the highest sagittal position of the hyoid bone, while those with skeletal Class II and hyperdivergent pattern had the lowest hyoid length. Nasopharyngeal airway space width was significantly lower in skeletal Class III patients, while volume and area were lower in hyperdivergent patients. Oropharyngeal and hypopharyngeal dimensions were also affected by skeletal class and growth pattern, with hyperdivergent patients having the lowest values. Total pharyngeal volume, area, and minimum constricted area were also affected, with hyperdivergent patients having the lowest values and skeletal Class II patients having the lowest minimum constricted area.
    CONCLUSIONS: Pharyngeal airway dimensions and hyoid bone parameters vary with malocclusions. The hyoid bone\'s position influences the airway, identifying patients at risk for airway obstruction and sleep-disordered breathing.
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  • 文章类型: Journal Article
    The initial treatment of open laryngeal trauma must be implemented immediately, with the primary focus on saving lives. However, in the later stages, various factors may cause changes in the structure and function of the larynx, which requires special attention. This article reports on the treatment process of a patient with depression who suffered from laryngeal trauma. Due to the late stage of laryngeal infection causing laryngeal defects, a hyoid epiglottis combined with sternocleidomastoid muscle clavicular flap repair was performed. Additionally, personalized functional exercise was performed, ultimately resulting in recovery.
    摘要: 开放性喉外伤的初始救治需争分夺秒,以抢救生命为主,但后期可能会因各种因素导致喉结构及功能的改变,需要特别重视。本文报道1例抑郁症患者喉外伤的救治过程,因为后期伴有喉感染引起喉缺损行舌骨会厌联合胸锁乳突肌锁骨瓣修复,并行个体化的功能锻炼,最后痊愈。.
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  • 文章类型: Journal Article
    本文报告烟台业达医院耳鼻咽喉科、烟台毓璜顶医院耳鼻咽喉科、烟台芝罘医院耳鼻咽喉科等三所医院从2008年2月至2023年8月收治的7例茎突舌骨韧带骨化假关节型的病例,介绍了茎突舌骨韧带骨化假关节类型的常见及特殊症状、体征、影像学特点,临床诊断要点等。7例患者中有4例接受手术治疗;3例拒绝手术治疗,采用咽部、颈部封闭及药物治疗。4例接受手术治疗的患者中有3例行经颈外进路手术,1例行经口内进路手术,术后3例患者症状消失,1例好转。3例保守治疗的患者中治疗后症状消失者1例,明显减轻者2例。.
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    文章类型: English Abstract
    目的:通过定量测量舌骨厚度,研究下颌阻生第三磨牙与舌骨厚度之间的潜在关系,建立舌骨三维可视化模型。
    方法:从合肥市口腔医院数据库收集200例下颌阻生第三磨牙的影像资料。采用SemtantPro软件对不同测量部位的舌骨进行厚度测量和三维重建。采用SPSS22.0软件包进行统计学分析,并使用秩和检验对不同测量部位的舌部厚度进行比较。以骨板厚度是否为“高危类型”为结果变量,对不同的相关因素进行logistic回归分析。
    结果:第三磨牙根中间点的舌骨最薄。多颗牙齿,mesio倾斜和刻度盘倾斜的牙齿,Ⅱ、Ⅲ类阻生牙舌骨薄(P<0.05)。观察到内侧和远端倾斜,Ⅱ类和Ⅲ类牙齿根尖区域的舌骨较薄(P<0.05)。在较低的受累牙齿中,Ⅲ类牙齿中冠部位舌骨较薄(P<0.05)。
    结论:舌骨的厚度与阻生牙根的数量有关,倾斜方向和冲击型。在拔除受影响的牙齿时,应考虑上述因素,和舌神经的损伤,舌骨及周围软组织应提高警惕。
    OBJECTIVE: The potential relationship between impacted mandibular third molar and lingual bone thickness was investigated by quantitative measurement of lingual bone thickness, and a three-dimensional visualization model of lingual bone was established.
    METHODS: Image data of 200 cases of mandibular impacted third molar were collected from the database of Hefei Stomatological Hospital. Thickness measurement and three-dimensional reconstruction of lingual bone at different measurement sites were performed by Simplant Pro software. Statistical analysis was performed using SPSS 22.0 software package, and the comparison of lingual thickness at different measurement sites was performed using rank sum test. Whether the thickness of bone plate was \"high-risk type\" was taken as the result variable, different related factors were analyzed by logistic regression.
    RESULTS: The lingual bone at the middle point of the root of the third molar was the thinnest. Multiple teeth, mesio-inclined and dial-inclined teeth, and Class Ⅱ and Ⅲ impacted teeth had thin lingual bone(P<0.05). The mesial and distal inclines were observed, and the lingual bone was thin in the root apical region of the teeth in Class Ⅱ and Class Ⅲ(P<0.05). In the lower impacted teeth, the thin lingual bone at the central crown site was more likely to be found in Class Ⅲ teeth(P<0.05).
    CONCLUSIONS: The thickness of lingual bone was related to the number of impacted tooth roots, tilt direction and impacted type. In the extraction of impacted teeth, the above factors should be considered, and the injury of lingual nerve, lingual bone and surrounding soft tissue should be vigilant.
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  • 文章类型: Case Reports
    颈动脉周围的骨骼结构,比如茎突和舌骨,会导致解剖,压缩,颈动脉斑块形成和斑块破裂。本研究旨在介绍一种新的舌骨伸长导致颈动脉夹层动脉瘤的病例。然而,患者无永久性神经系统症状.尽管使用抗血小板和他汀类药物进行了预防性治疗,但一名80岁的男子仍出现右侧偏瘫>5小时。磁共振成像显示左顶叶急性梗塞。对比增强计算机断层扫描显示两个囊肿,其中一些钙化位于右颈内动脉(ICA)的分叉处和与右ICA相邻的舌骨的右大角。颈动脉血管的彩色双工扫描证实了夹层动脉瘤与舌骨之间的关系。总之,应更加注意颈动脉周围的骨性结构。
    Bony structures around the carotid artery, such as the styloid process and the hyoid bone, can cause dissection, compression, plaque formation and plaque rupture of the carotid artery. The present study aimed to present a novel case of hyoid bone elongation causing dissecting aneurysm of the carotid artery. However, the patient had no permanent neurologic symptoms. An 80-year-old man presented with right hemiparesis for >5 h despite preventive therapy with antiplatelets and statins. Magnetic resonance imaging revealed acute infarction in the left parietal lobe. Contrast-enhanced computed tomography revealed two cysts with some calcification located at the bifurcation of the right internal carotid artery (ICA) and the right greater horn of the hyoid bone adjacent to the right ICA. A color duplex scan of the carotid vessels confirmed the relationship between dissecting aneurysm and the hyoid bone. In conclusion, greater attention should be paid to the bony structures around the carotid artery.
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  • 文章类型: Journal Article
    目的:本研究主要旨在分析咽气道(PA)的三维(3D)变化,其次,对患有颞下颌关节紊乱病(TMD)和下颌偏斜(MD)的成年患者进行稳定夹板(SS)治疗后的舌骨(HB)和颅颈(CC)。
    方法:35例成人TMD和MD患者,使用SS治疗的平均年龄为25.14岁,参加了这项回顾性临床研究。分析了治疗前后的锥形束计算机断层扫描(CBCT)扫描。PA尺寸(鼻咽,口咽,下咽,下咽下,测量咽气道空间的表面积,volume,最小收缩面积(MCA)和宽度),使用InVivo6.0.3和Dolphin11.95软件对HB位置和CC姿势进行三维分析。进行Wilcoxon秩和或配对t检验,P<0.05被认为是显著的。
    结果:SS治疗的时间为9.49±4.02个月。口咽气道间隙显示矢状宽度显著减小。下咽表面积,volume,MCA和矢状宽度显著下降。就HB而言,舌骨-下颌平面(H-MP),下颌后第三椎骨的最下前(RGN-C3ia)和下颌后西拉(RGN-S)距离显着减少。在CC姿势中,Nasion-Sella线和通过C2ip到达齿状突后切(NSL-OPT)角的线也显着降低。
    结论:SS治疗TMD患者主要导致下咽区狭窄,HB位置无变化,头部姿势无改善。这些结果无疑有助于临床病症的诊断和治疗。
    OBJECTIVE: This study aimed primarily to analyze the three-dimensional (3D) changes in the pharyngeal airway (PA), and secondarily, the hyoid bone (HB) and the craniocervical (CC) following stabilization splint (SS) therapy in adult patients with temporomandibular joint disorders (TMD) and mandibular deviation (MD).
    METHODS: Thirty-five adult patients with TMD and MD, who were treated using SS with a mean age of 25.14 ± 6.11 years, were enrolled in this retrospective clinical study. Pre- and post-therapeutic cone-beam computed tomography (CBCT) scans were analyzed. PA dimension,nasopharyngeal, oropharyngeal, hypopharyngeal, sub-hypopharyngeal, and total pharyngeal airway spaces were measured in surface area, volume, minimum constricted area (MCA) and width, HB position, and CC posture were analyzed three-dimensionally using InVivo 6.0.3 and Dolphin 11.95 software. Wilcoxon rank-sum or Paired t-test was conducted, and P < 0.05 was considered significant.
    RESULTS: SS therapy was administered for a period of 9.49 ± 4.02 months. The oropharyngeal airway space showed a significant decrease in sagittal width. The hypopharyngeal surface area, volume, MCA, and sagittal width decreased significantly. In terms of HB, hyoid-mandibular plane (H-MP), retrognathia-third vertebra\'s most inferior-anterior (RGN-C3ia), and retrognathia-Sella (RGN-S) distances significantly decreased. The Nasion-Sella line and the line that passes through C2ip to the odontoid process posterior tangent (NSL-OPT) angle in CC posture also decreased significantly.
    CONCLUSIONS: SS therapy in TMD patients with MD mainly results in narrowing of the hypopharyngeal region, no change in HB position and improvement in head posture. These results undoubtedly assist in diagnosis and treatment of clinical conditions.
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  • 文章类型: Journal Article
    背景:这项研究旨在评估和比较接受Invisalign下颌前移(MA)和Twin-Block(TB)矫治器治疗的II类下颌后移儿童上呼吸道形态和舌骨位置的改善,利用锥形束计算机断层扫描(CBCT)。
    方法:本研究包括32名年龄在8至11.5岁之间的儿童,平均年龄10.2岁。这些孩子被分成两组,MA和TB,每组有16个孩子。采用CBCT分析治疗前后上气道形态及舌骨位置的变化。
    结果:(1)治疗前后上呼吸道的变化:口咽容积(Or-V),口咽最小横截面积(Or-mCSA),下咽容积(Hy-V),治疗后,MA和TB组的下咽最小横截面积(Hy-mCSA)增加,与治疗前相比,差异有统计学意义(P<0.05)。(2)治疗前后舌骨位置的变化:H点与第三颈椎(H-C3)之间的距离,H点和指针(H-RGN),H点和下颌平面(H-MP),H点和法兰克福水平面(H-FH),H和S点(H-S),治疗后MA和TB组的H点和腭平面(H-PP)均增加,差异均有统计学意义(P<0.05)。
    结论:MA和TB矫治器均有效改善了上呼吸道的结构狭窄并降低了呼吸阻力,从而改善呼吸质量。然而,与TB相比,MA在改善下咽最窄部分方面表现出更高的效力。两种矫治器也促进舌骨向前向下运动,打开口咽和下咽的上呼吸道,帮助上呼吸道形态恢复到正常范围。
    This study is to evaluate and compare the improvement of upper airway morphology and hyoid bone position in children with Class II mandibular retrusion treated with Invisalign mandibular advancement (MA) and Twin-Block (TB) appliances, utilizing cone beam computed tomography (CBCT).
    32 children aged between 8 and 11.5 years old were included in this study, with an average age of 10.2 years old. These children were divided into two groups, MA and TB, with 16 children in each group. Changes in upper airway morphology and hyoid bone position before and after treatment were analyzed using CBCT.
    (1) Changes in upper airway before and after treatment: the oropharynx volume (Or-V), the oropharynx minimum cross-sectional area (Or-mCSA), the hypopharynx volume (Hy-V), and the hypopharynx minimum cross-sectional area (Hy-mCSA) in both the MA and TB groups increased after treatment, and the differences were statistically significant (P < 0.05) compared to pre-treatment status. (2) Changes in hyoid bone position before and after treatment: The distances between H point and third cervical vertebra (H-C3), H point and pogonion (H-RGN), H point and mandibular plane (H-MP), H point and Frankfort horizontal plane (H-FH), H and S point (H-S), and H point and palatal plane (H-PP) in both the MA and TB groups increased after treatment, and the differences were statistically significant (P < 0.05).
    Both MA and TB appliances effectively improved the structural narrowness of the upper airway and reduced respiratory resistance, thus improving breath quality. However, MA showed more effectiveness in improving the narrowest part of the hypopharynx compared to TB. Both appliances also promoted anterior downward movement of the hyoid bone, which opens the upper airway of the oropharynx and hypopharynx and helps the upper airway morphology return to normal range.
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  • 文章类型: Journal Article
    背景:以三维方式评估III类错牙合成人下颌牙列扩张正畸治疗前后下颌前牙周围牙槽骨和咽气道尺寸的变化。
    方法:在这项回顾性研究中,在治疗前后对20例进行下颌牙列扩张的III类错牙合畸形患者进行了锥形束计算机断层扫描(CBCT)扫描。评估并比较了下颌切牙和犬齿周围厚度和垂直边缘骨水平的三维变化。腭的气道体积-,glosso-,测量并比较治疗前后的咽喉和最小轴向面积。
    结果:下颌切牙舌骨厚度明显下降,观察犬唇骨和舌骨的部分厚度(P<0.05)。门牙和犬齿的根长减少,正畸治疗后,唇和舌垂直边缘骨水平显着。下颌牙列扩张与咽气道尺寸之间没有显着相关性。
    结论:下颌牙列扩张可导致III类错牙合中前牙周围牙槽骨丢失,尤其是颈椎边缘骨.扩张后咽部气道尺寸没有受到很大程度的影响。
    背景:追溯注册。
    BACKGROUND: To three-dimensionally evaluate changes of the alveolar bone around the mandibular anterior teeth and pharyngeal airway dimensions in adults with Class III malocclusion before and after orthodontic treatment of mandibular dentition distalization.
    METHODS: In this retrospective study, cone-beam computed tomography (CBCT) scans of 20 patients with Class III malocclusion who underwent mandibular dentition distalization were obtained both before and after treatment. Three-dimensional changes of the thickness and vertical marginal bone levels around mandibular incisors and canines were assessed and compared. And airway volumes of the palato-, glosso-, laryngopharynx and the minimum axial area were measured and compared before and after treatment.
    RESULTS: A significant decrease of lingual bone thickness of mandibular incisors, partial labial and lingual bone thickness of canines were observed (P < 0.05). The reduction in root length of incisors and canines, labial and lingual vertical marginal bone levels were significant after orthodontic treatment. No significant correlations between mandibular dentition distalization and pharyngeal airway dimensions were observed.
    CONCLUSIONS: Mandibular dentition distalization could result in the loss of alveolar bone around anterior teeth in Class III malocclusion, especially for the cervical marginal bone. Pharyngeal airway dimensions were not affected to a high extent after distalization.
    BACKGROUND: Retrospctively registered.
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  • 文章类型: Observational Study
    目的:术前评估困难气道是必要的,尤其是新生儿。经腹距离是预测成人困难气道的可靠指标。然而,很少有研究评估了经膜距离对预测新生儿困难气道的价值。目前尚不清楚使用直接喉镜检查时,下网膜距离是否预测有限或困难的视野。我们打算开发一种有效的系统来预测新生儿困难的气管插管。
    方法:前瞻性观察性临床研究。
    方法:选择全麻下行直接喉镜经口气管插管行择期手术的0~28天新生儿。超声评估舌膜距离和舌骨水平组织厚度。其他参数,例如下颌长度和胸骨距离,在麻醉前也进行了评估。喉镜下的声门结构视图根据Cormack-Lehane分类进行分级。具有1级和2级喉视的患者被分配到E组。具有3级和4级喉视的患者被分配到D组。
    结果:共招募123名新生儿用于我们的研究。在我们的研究中,喉镜检查期间喉部可视化不良的发生率为10.6%。多因素logistic回归结果显示,下叶距离是喉镜检查困难的有力预测因素(OR=0.16,95%CI0.03-0.74,P=0.019)。灵敏度和特异度最高的曲线和最大的曲线下面积(AUC)是下叶距离。hyomental距离的接收器工作特性(ROC)曲线表明,最佳截止值小于等于2.74cm,AUC为0.80(95%CI0.64-0.95)。
    结论:在新生儿中使用超声精确测量下网膜距离是无创和可行的,结果可靠。我们认为,用超声测量的鼻孔距离可以用作预测新生儿喉镜检查困难的标志。
    Preoperative evaluations of difficult airways are imperative, especially in newborns. The hyomental distance is a reliable index for predicting difficult airways in adults. However, few studies have evaluated the value of the hyomental distance for predicting difficult airways in newborns. It is unclear whether the hyomental distance forecasts a restricted or difficult view when using direct laryngoscopy. We intended to develop an effective system for predicting difficult tracheal intubation in newborns.
    A prospective observational clinical study.
    Newborns aged 0 to 28 days undergoing oral endotracheal intubation with direct laryngoscopy for elective surgery under general anesthesia were enrolled. The hyomental distance and hyoid level tissue thickness were assessed by ultrasound. Other parameters, such as the mandibular length and sternomental distance, were also evaluated before anesthesia. The glottic structure view under laryngoscopy was graded according to the Cormack-Lehane classification. The patients with Grade 1 and 2 laryngeal views were assigned to Group E. Those with Grade 3 and 4 views were assigned to Group D.
    A total of 123 newborns were recruited for our study. The incidence of poor visualization of the larynx during laryngoscopy in our study was 10.6%. The multifactor logistic regression results showed that the hyomental distance was a powerful predictor of difficult laryngoscopy (OR = 0.16, 95% CI 0.03-0.74, P = .019). The curve with the highest sensitivity and specificity and the maximum area under the curve (AUC) was the hyomental distance. The receiver operating characteristic (ROC) curve for the hyomental distance suggested that the best cut-off value was less than equal to 2.74 cm, with an AUC of 0.80 (95% CI 0.64-0.95).
    It is noninvasive and feasible to accurately measure the hyomental distance with ultrasound in newborns, and the results are reliable. We believe that the hyomental distance measured with ultrasound could be used as a marker for predicting difficult laryngoscopy in newborns.
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  • 文章类型: Journal Article
    舌骨的发育是一个复杂的过程,涉及多个信号通路的协调。先前的研究表明,小鼠刺猬通路的破坏会导致一系列结构畸形。然而,hedgehog通路在舌骨早期发育中的具体作用和关键期尚未得到充分描述。在这项研究中,我们用hedgehog通路抑制剂vismodegib口服灌胃治疗妊娠ICR小鼠,以建立舌骨发育不良模型。我们的结果表明,在胚胎期11.5(E11.5)和E12.5天给予vismodegib会导致舌骨发育不良的发展。通过使用细致的时间分辨率,我们能够定义诱发舌骨畸形的关键时期。我们的发现表明,刺猬通路在舌骨的早期发育中起着至关重要的作用。此外,我们的研究使用一种市售的途径选择性抑制剂,建立了一种新颖且易于建立的舌骨骨滑膜模型.
    The development of the hyoid bone is a complex process that involves the coordination of multiple signaling pathways. Previous studies have demonstrated that disruption of the hedgehog pathway in mice results in a series of structural malformations. However, the specific role and critical period of the hedgehog pathway in the early development of the hyoid bone have not been thoroughly characterized. In this study, we treated pregnant ICR mice with the hedgehog pathway inhibitor vismodegib by oral gavage in order to establish a model of hyoid bone dysplasia. Our results indicate that administration of vismodegib at embryonic days 11.5 (E11.5) and E12.5 resulted in the development of hyoid bone dysplasia. We were able to define the critical periods for the induction of hyoid bone deformity through the use of a meticulous temporal resolution. Our findings suggest that the hedgehog pathway plays a crucial role in the early development of the hyoid bone. Additionally, our research has established a novel and easily established mouse model of synostosis in the hyoid bone using a commercially available pathway-selective inhibitor.
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