Simple laryngeal suspension procedure by suturing the digastric muscle to the periosteum of the mandible in neck dissection for tongue cancer

Am J Otolaryngol. 2018 Mar-Apr;39(2):77-81. doi: 10.1016/j.amjoto.2018.01.008. Epub 2018 Jan 31.

Abstract

Purpose: In this article, a simple, new laryngeal suspension procedure is described. The effect of hyoid bone suspension by suturing the digastric muscle to the periosteum of the mandible is analyzed.

Materials and methods: To elucidate the effect of hyoid bone suspension, CT scans of 26 patients who underwent ipsilateral neck dissection with primary resection of tongue cancer were retrospectively reviewed, and the distance between the hyoid bone and the mandible was measured on the operated and unoperated sides of the neck. A total of 14 patients who underwent suturing of the digastric muscle to the mandible (digastric muscle-sutured group) and the 12 patients who did not (control group) were compared.

Results: In the digastric muscle-sutured group, the average distance between the hyoid bone and the mandible was significantly smaller on the operated side (17.8 ± 0.57 mm) than on the unoperated side (19.8 ± 0.93 mm; p < 0.05). In the control group, there was no significant difference between the operated side (21.0 ± 1.42 mm) and the unoperated side (19.7 ± 1.39 mm). The difference in the distance between the operated and unoperated sides was significantly larger in the digastric muscle-sutured group (1.97 ± 0.79 mm) than in the control group (-1.32 ± 0.61; p < 0.05).

Conclusions: It was shown for the first time that suturing of the digastric muscle to the periosteum of the mandible in neck dissection with primary resection of tongue cancer resulted in hyoid bone suspension. This simple procedure can be useful for laryngeal suspension.

Keywords: Digastric muscle; Laryngeal suspension.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Follow-Up Studies
  • Humans
  • Larynx / surgery
  • Male
  • Mandible / surgery*
  • Middle Aged
  • Neck Dissection / methods*
  • Neck Muscles / surgery*
  • Oral Surgical Procedures / methods*
  • Periosteum / surgery*
  • Retrospective Studies
  • Suture Techniques / instrumentation*
  • Sutures
  • Tongue Neoplasms / diagnosis
  • Tongue Neoplasms / surgery*
  • Young Adult