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Salivary Gland Tumours
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
The fundamental principle of a parotidectomy is exposure of the FN and then removal of the gland and diseased tissue from around it. The branching pattern of the FN can vary, and the nerve may be displaced from its normal position by tumour. The FN monitor can aid identification of the nerve and manipulation of the tissues around it. The FN trunk can be identified by several anatomical landmarks: Tragal pointer: inferior portion of cartilaginous external auditory canal. FN lies 1 cm deep and inferior to its tip.Tympanomastoid suture: FN lies immediately deep and inferior to this at its point of exit from the skull.Posterior belly of the digastric muscle: FN leaves the skull immediately anterior to the attachment of this muscle.Styloid process: lies deep to the exit of the FN from the skull, so care must be taken using this landmark.Retrograde dissection: of terminal FN branches.
The spectrum of voice disorders – classification
Published in Stephanie Martin, Working with Voice Disorders, 2020
Many patients report experiencing a feeling of ‘having a lump in their throat’ and, while an occasional sensation of a lump in the throat is relatively common in the presence of strong emotion, when, for example, trying not to cry or when having to ‘swallow one’s feelings’, true globus is usually experienced persistently. Patients will report discomfort, will try to swallow, cough or clear the throat in order to dislodge this sensation. While globus symptoms may have both psychogenic and physical origins, all patients should undergo careful examination to exclude the presence of disease or malignant tumour. Some possible causes of globus, in addition to stress and anxiety, are pharyngeal inflammatory conditions, GORD, abnormal upper oesophageal sphincter function, rare tumours, thyroid disease or previously lodged objects which were not completely removed. Other possible but relatively rarely documented causes, therefore needing more studies to confirm their findings, are temporo-mandibular joint (TMJ) disorders, an inability to produce enough saliva, cervical osteophytes or bone spurs and Eagle’s syndrome. Eagle’s syndrome is a condition associated with the elongation of the styloid process or calcification of the stylohyoid ligament, clinically characterised by throat and neck pain, radiating into the ear.
Oropharynx
Published in Neeraj Sethi, R. James A. England, Neil de Zoysa, Head, Neck and Thyroid Surgery, 2020
It is shaped like an inverted pyramid with its base at the skull base and apex inferiorly pointing to the greater cornu of the hyoid bone (Figure 9.4). It is split into two components (pre- and post-styloid) by the styloid process of the skull base (see Tables 9.1 and 9.2).
Comparison between landmark and ultrasound-guided percutaneous peristyloid glossopharyngeal nerve block for post-tonsillectomy pain relief in children: a randomized controlled clinical trial
Published in Egyptian Journal of Anaesthesia, 2022
Abdelrhman Alshawadfy, Ahmed A. Ellilly, Ahmed M. Elewa, Wesam F. Alyeddin
Additionally, Ažman et al. [9] assessed the technical feasibility of a distal GPN block via the parapharyngeal space in the cadavers and healthy volunteers. An US-guided block of the distal GPN was technically feasible, successful, and safe via the pharyngeal wall level. Also for primary GP neuralgia, Liu et al. [12] evaluated the efficacy and safety of US-guided GPN block. After 18 months follow-up, GPN block via post-styloid process approach was considered a safe, radiation-free, repeatable, convenient, and effective treatment. However, Liu et al. studied only 12 patients retrospectively with no randomization. Furthermore, Fukui [27] did not recommend blind insertion of the needle or changing its position. This was due to the vital structures located around the styloid process, such as the vagus nerve, accessory nerve, hypoglossal nerve, facial nerve, sympathetic nerve, and internal carotid vessels. Hence, the US-guided GPN block was preferred to clarify these structures. However, it was difficult to confirm the styloid process under US guidance. The styloid process was located in a shallower area than expected in some patients. However, in the present study both US-guided and the LM techniques of GPN block were safe. We inserted the needle posteriorly to the styloid process during the US-guided approach, while Fukui inserted the needle through the ventral aspect of the styloid process.
Styloidogenic Jugular Venous Compression Syndrome with Papilloedema: Case Report and Review of the Literature
Published in Neuro-Ophthalmology, 2022
Alvaro Jose Mejia-Vergara, William Sultan, Angelos Kostas, Celene Bardales Mulholland, Alfredo Sadun
Eagle’s syndrome (ES), due to an enlarged styloid process, was first described in 1937 by Dr. W.W. Eagle in Duke University.3 The underlying anatomical abnormality found in Eagle Syndrome is the elongation and calcification of the styloid process, either unilaterally or bilaterally.4 It can manifest in one of three ways: 1) the classic presentation; 2) associated with carotid compression; and 3) associated with an IIH-like syndrome.4 The classic presentation consists of neck pain, dysphagia, foreign body sensation, otalgia, pain with yawning, or pain on turning of the head.2,4,5 The second clinical presentation is associated with carotid artery compression, transient ischaemic attacks, Horner’s syndrome, and stroke.2,4–6 It has been estimated that 4–7.3% of the population has an elongated styloid process, defined as 30 mm or longer.4,7
Incidence of distal ulna fractures in a Swedish county: 74/100,000 person-years, most of them treated non-operatively
Published in Acta Orthopaedica, 2020
Maria Moloney, Simon Farnebo, Lars Adolfsson
Fractures of the distal ulna are not very common, especially when excluding fractures of the ulnar styloid, and are most often found with a concomitant distal radius fracture. Our findings showed an incidence of 74/100 000 person-years in adults living in Östergötland, Sweden, during 2010–2012. Most common were fractures of the ulnar styloid (79% Q1) followed by fractures of the ulnar neck (11% Q2). Herzberg and Castel (2016) found that, excluding styloid fractures, 9% of patients with a distal radius fracture also have a distal ulna fracture. They defined the distal ulna as the ulnar head and neck without further specification and not the distal third of the ulna as in the present study. 5.9% were a fracture of the ulnar neck, 1.6% a fracture of both the head and neck, and 1.4% a fracture of ulnar head (Herzberg and Castel 2016). Simultaneous fractures of both radius and ulna could negatively affect the outcome by causing problems of incongruence of the DRUJ and increase the risk of nonunion. Styloid process fractures that include metaphysis often heal; however, when the styloid process is fractured separately from the metaphysis it often does not (Biyani et al. 1995).