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The Hyoid Bone01:12

The Hyoid Bone

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The hyoid bone is a small U-shaped bone located in the upper neck at the level of the inferior mandible, with its tips pointing posteriorly. It does not directly articulate with any other bone in the body. The hyoid acts as the attachment site for the tongue, the larynx, and the pharynx. It is held in position by a series of small muscles attached from above or below. These muscles help to move the hyoid up/down or forward/back in coordination with movements of the tongue, larynx, and pharynx...
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Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
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Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
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Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
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Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
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Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
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Dynamic Internal Jugular Vein Compression by Hypertrophic Hyoid Bone: Management and Outcomes.

Soliman Oushy1, John T Wald2, Jeffrey Janus3

  • 1Neurological Surgery, Mayo Clinic, Rochester, USA.

Cureus
|May 1, 2020
PubMed
Summary

Extracranial osseous compression of the internal jugular vein (IJV) is rare and difficult to diagnose. Surgical decompression relieved positional facial pain caused by hyoid bone impingement on the IJV.

Keywords:
atypical facial paincompressiondynamichyoid boneinternal jugular vein

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Area of Science:

  • Vascular Surgery
  • Anatomy
  • Pain Management

Background:

  • Extracranial osseous compression of the internal jugular vein (IJV) is a rare condition.
  • Clinical presentation of IJV obstruction is often subtle and heterogeneous, posing diagnostic challenges.

Observation:

  • A 40-year-old male presented with progressive, positional right periorbital and neck pain, and photosensitivity.
  • Imaging revealed a hypertrophic hyoid bone causing dynamic compression of the right IJV.

Findings:

  • Computed tomography venogram confirmed dynamic compression of the IJV by hypertrophied hyoid bone and thyroid cartilage.
  • Surgical decompression of the IJV led to complete symptom resolution.

Implications:

  • Extracranial IJV impingement can manifest as atypical facial pain, particularly when positional.
  • This diagnosis should be considered in patients with unexplained facial pain, especially if positional.
  • Disturbances in extracranial IJV outflow may be an underrecognized cause of atypical facial pain.