[The hyoid bone in reconstructive laryngeal and cervical surgery]

Area of Science:

• Head and Neck Surgery
• Surgical Oncology
• Anatomy

Context:

• Larynx and cervical surgeries often require extensive tissue removal, particularly for advanced cancers.
• Reconstruction of the upper respiratory tract and cervical structures presents significant challenges.
• The hyoid bone's anatomical features offer unique advantages in reconstructive procedures.

Purpose:

• To highlight the critical role of the hyoid bone as an anchor point in larynx and cervical reconstructive surgery.
• To underscore the importance of preserving the hyoid bone in radical surgical interventions.
• To present clinical data supporting the hyoid bone's utility in various reconstructive techniques.

Summary:

• The hyoid bone serves as a robust anchor in larynx tumor surgeries requiring reconstruction.
• It is vital in cervical reconstructive surgery, especially after extensive tissue removal in advanced larynx, thyroid, or pharyngoesophageal cancers.
• Clinical data from 39 patients (38 larynx cancer, 1 thyroid cancer) demonstrate its application.
• Techniques like horizontal supraglottic laryngectomy (HSL) and subtotal larynx surgery (CHEP, CHP) utilize the hyoid bone for neo-larynx creation.
• In extensive resections like forward widened total laryngectomy (FWTL), it anchors myocutaneous flaps for continuity.
• The hyoid bone's resistance and mobility make it a versatile support apparatus in cervical reconstruction.

Impact:

• Preservation of the hyoid bone enhances reconstructive outcomes in complex head and neck surgeries.
• It facilitates the creation of a functional neo-larynx and secures critical flaps, improving patient recovery.
• This approach offers a valuable strategy for surgeons dealing with locally advanced or recurrent head and neck malignancies.