Hyoid bone syndrome is a disease caused by an abnormality in the apparatus hyoideus, indicated by a variety of symptoms such as a feeling of discomfort in the pharyngolarynx, neck pain, a clicking sound when twisting the neck, etc. We report on two cases of hyoid bone syndrome accompanying an excessively long greater cornu of the hyoid bone.
Case 1 consulted the hospital with the excessively long of discomfort when swallowing along with a clicking sound when swallowing from several years prior. The greater cornu of the hyoid bone on both sides was found to be long upon neck CT, in addition to approaching the transverse process of the fourth cervical vertebra. Case 2 became aware of neck pain from 1 year prior and consulted the hospital due to exacerbation of the symptoms. The excessively long greater cornu of the hyoid bone was observed on both sides of neck on CT imaging, with the greater cornu of the hyoid bone approaching the transverse process of the third cervical vertebra. From the above, the patient was diagnosed with hyoid bone syndrome accompanying an excessively long greater cornu of the hyoid bone on both sides, with prominent improvement in symptoms observed when partial resection of the bilateral greater cornu of the hyoid bone was carried out, yielding good results.
Although such cases may be diagnosed as pharyngolaryngeal paresthesia, when symptoms are observed over a long period of time and the complaint is strong and clear, an in-depth examination including imaging testing is required. Moreover, it was believed that resection of the greater cornu of the hyoid bone is a useful treatment for hyoid bone syndrome.
A 3.5-year-old female Chihuahua was presented with complaint of neck pain, intermittent cough and dysphagia. Physical examination and diagnostic imaging of neck region revealed a solid and highly vascularized mass involving the retropharyngeal region. Histologically, the mass showed an atypical zellballen pattern which comprised of high density of type I chief cells with high nuclear cytoplasmic ratio and separated by delicate fibrovascular stroma. Immunoreactivity for neuroendocrine markers was diffusely positive in cytoplasm of tumor cells. Disseminated tumor emboli in external jugular vein were detected 6 months after initial surgery. An electron microscopic study revealed numerous electron-dense intracytoplasmic neurosecretory granules. Based on these findings, carotid body carcinoma was diagnosed.
Objective: We examined the usefulness of Doppler ultrasonography for the diagnosis of severe stenosis of the proximal vertebral artery (VA).
Case Presentations: We performed Doppler ultrasonography of the VA in patients diagnosed with cerebral ischemia of the posterior circulation. Incorporating the diagnostic criteria for severe stenosis at the origin of the internal carotid artery (maximum peak systolic flow velocity: ≥200 cm/sec, or acceleration time: ≥110 msec), patients were screened for proximal VA stenosis and cerebral angiography was conducted if they fulfilled the above criteria. In all six patients in whom proximal VA stenosis was suspected on ultrasonography, angiography confirmed severe stenosis, and endovascular treatment was performed. In five patients who underwent postoperative ultrasonography, an improvement of the stenosis was confirmed.
Conclusion: Doppler ultrasonography is useful for the screening and postoperative assessment of proximal VA stenosis.
Purpose: We report a patient who underwent stenting for dissection related to internal-shunt insertion during carotid endarterectomy (CEA).
Case Presentation: A 77-year-old female with a history of stenosis of the left carotid artery. During admission due to infectious enteritis, right hemiplegia occurred, and arteriogenic embolism was observed. After an improvement in the general condition was achieved, CEA was performed. Intimal thickening involving the periphery to the most stenotic site was noted. When inserting a shunt into the internal carotid artery, there was a resistance, and there was no blood flow regurgitation, suggesting iatrogenic dissection. After plaque removal and vascular suture, the patient was transferred to the angiography room while maintaining general anesthesia, and a stent was inserted to the site of dissection. Anterograde blood flow was achieved, and the postoperative course was favorable.
Conclusion: Stenting for carotid artery dissection related to shunt insertion during CEA may be effective.