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Extracorporeal membrane oxygenation
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Thomas Pranikoff, Ronald B. Hirschl
The platysma muscle and subcutaneous tissues are divided with electrocautery and the sternocleidomastoid muscle is exposed. Dissection is continued bluntly between the sternal and clavicular heads of the muscle. The omohyoid muscle will be seen superiorly. It may be necessary to divide the omohyoid muscle tendon to expose the carotid sheath. Two alternating self-retaining retractors are placed (Figure 14.3).
Anatomy and differential diagnosis in head and neck surgery
Published in Neeraj Sethi, R. James A. England, Neil de Zoysa, Head, Neck and Thyroid Surgery, 2020
The carotid triangle runs from the posterior belly of the digastric muscle to its insertion at the mastoid tip, then down the posterior border of the sternomastoid muscle, then up along the omohyoid muscle towards the lesser cornu of the hyoid. The omohyoid muscle is palpable in slim or muscular patients. As a surrogate, a line can be made from the lower two-thirds of the sternomastoid muscle to the lesser cornu of the hyoid.
Treatment of adjacent segment disease after total disc replacement (TDR)
Published in Gregory D. Schroeder, Ali A. Baaj, Alexander R. Vaccaro, Revision Spine Surgery, 2019
The key principles of revision anterior cervical surgery are careful preoperative planning and meticulous dissection. Preoperative imaging should assure the surgeon that there are no anatomical nor index surgery anomalies. These anomalies can be planned for and hopefully avoided. Next is the approach dissection. Typically, little significant scarring occurs anterior to the pretracheal fascia. Posterior to the pretracheal fascia, the esophagus and the carotid sheath are vulnerable to injury. To avoid these structures, the surgeon should extend the dissection either proximal or distal to that of the index procedure. This extended dissection will allow a more normal plane between these structures to expose the anterior aspect of the vertebral bodies between the longus colli muscle masses. The dissection should be done bluntly to avoid visceral or vascular injuries. If exposure is initially required distally, the omohyoid muscle may be transected. The vascular supply for the omohyoid is in the cranial third of the muscle. Once the midline is exposed, sharp dissection can be used to elevate the vertebral body scar tissue. From there, surgery proceeds as with the primary procedures.
Anatomical aspects of the selective infraspinatus muscle neurotization by spinal accessory nerve
Published in Journal of Plastic Surgery and Hand Surgery, 2021
Radek Kaiser, Aneta Krajcová, Michal Makel, Gautham Ullas, Veronika Němcová
SSN arises from the upper trunk of the brachial plexus which is formed by the union of the ventral rami of the C5 and C6 and rarely from C4 root. The nerve passes across the posterior triangle of the neck parallel to the inferior belly of the omohyoid muscle and deep to the trapezius muscle. It then runs along the superior border of the scapula, passes through the suprascapular notch inferior to the superior transverse scapular ligament and enters the supraspinous fossa. It then passes beneath the supraspinatus, relatively fixed on the floor of the supraspinatus fossa, and curves around the lateral border of the spine of the scapula through the spinoglenoid notch to the infraspinous fossa. In 84%, there were no more than two motor branches to the supraspinatus muscle and in 48% the infraspinatus muscle had three or four motor branches of the same size [11]. The mean diameter of the suprascapular nerve at the suprascapular notch is 2.48 ± 0.6 mm [12].
Anterolateral approach for subaxial vertebral artery decompression in the treatment of rotational occlusion syndrome: results of a personal series and technical note
Published in Neurological Research, 2021
Sabino Luzzi, Cristian Gragnaniello, Alice Giotta Lucifero, Stefano Marasco, Yasmeen Elsawaf, Mattia Del Maestro, Samer K. Elbabaa, Renato Galzio
Platysma is freed from the skin layer, generally for 3 to 4 cm away from the site of the incision, in order to avoid any traction. It is then cut longitudinally, along the course of its fibers. The anterior border of the SMC is identified, with the carotid sheath coursing beneath it and containing the internal carotid artery (ICA), internal jugular vein (IJV) and vagus nerve. A pre-sternocleidomastoid precarotid exposure is carried out (Figure 1(d)). Omohyoid muscle is then isolated at a deeper level, encircled with a vessel loop and medialized (Figure 1(e)). Sternothyroid muscle, esophagus and trachea are left medially. The widening of the avascular plane between the SMC laterally and trachea and esophagus medially allows for easy identification of the pre-vertebral fascia. The fascial opening exposes the vertebral body and the medial border of the longus colli muscles. Moving laterally under microscopic vision leads to the identification of the lateral border of the ipsilateral longus colli. In a further lateral position, longus capitis and anterior scalene muscle are just lateral to the longus colli at C3-C4 and C4-C5, respectively.
Study of arytenoid adduction performed under general anesthesia
Published in Acta Oto-Laryngologica Case Reports, 2019
Yu Saito, Ryoji Tokashiki, Kiyoaki Tsukahara
When using general anesthesia, nerve-muscle flap placement would be very useful for the reasons mentioned above. In a study by Tucker et al. [12], improvement in the voice of patients with laryngeal paralysis was achieved by grafting a nerve-muscle flap onto the vocal cord muscle, obtaining the flap from the ansa cervicalis and omohyoid muscle. In addition, May et al. [13] obtained improvements in the voice by grafting a nerve-muscle flap onto the lateral cricoarytenoid muscle. Furthermore, Yumoto et al. used a nerve-muscle flap made from the sternohyoid muscle and a nerve thicker than the ansa cervicalis, and employed a nerve-stimulating device during surgery. They found that placement of the flap after confirming adequate activity using the device achieved very good outcomes [14–16]. In neck dissection patients, when a nerve-muscle flap cannot be obtained from the affected side, a flap can usually be taken from the unaffected side. However, in rare cases, a flap may not be obtainable from bilateral neck surgery patients because of tumor invasion or other reasons.