1.Imaging analysis of the posterior occipital muscles in cervical vertigo based on shear wave elastography.
Ying-Sen PAN ; Yi SHEN ; Fei-Peng QIN ; Hao-Yang ZHANG ; Nao LIU ; Yan-Jun XU ; Xiao-Ming YING
China Journal of Orthopaedics and Traumatology 2025;38(11):1126-1132
OBJECTIVE:
To evaluate the partial biomechanical properties of the posterior occipital muscles (rectus capitis posterior major, rectus capitis posterior minor, and obliquus capitis inferior) in patients with cervical vertigo.
METHODS:
A total of 30 patients with cervical vertigo admitted from April 2024 to September 2024 were included in the vertigo group, and 30 age-and gender-matched healthy subjects were recruited as the normal group. In the vertigo group, there were 21 females and 9 males, with an average age of (24.00±2.25) years;in the normal group, there were 22 females and 8 males, with an average age of (23.00±3.00) years. Shear wave elastography was used to measure the thickness and stiffness of the posterior occipital muscles in both groups.
RESULTS:
In the vertigo group, there were no statistically significant differences in the Young's modulus values (E) of stiffness of the posterior occipital muscles (rectus capitis posterior major, rectus capitis posterior minor, obliquus capitis inferior) between the left and right sides(P>0.05). The Young's modulus values(E) of stiffness of the right posterior occipital muscles (rectus capitis posterior major, rectus capitis posterior minor, obliquus capitis inferior) in the cervical vertigo group were (39.66±8.21) kPa, (45.61±5.85) kPa, and (43.73±5.22) kPa, respectively, which were significantly higher than those in the normal group 33.97(17.76) kPa, 41.38(8.99) kPa, 38.27(12.58) kPa, with statistically significant differences (P<0.05). In the vertigo group, the Young's modulus values(E) of stiffness of the left rectus capitis posterior major and left obliquus capitis inferior were (40.41±9.13) kPa and (42.11±6.20) kPa, respectively, which were significantly greater than those in the normal group (33.30±11.31) kPa, 38.94(14.62) kPa, with statistically significant differences(P<0.05);however, there was no statistically significant difference in the left rectus capitis posterior minor between the two groups(P>0.05). In the vertigo group, there were no statistically significant differences in the stiffness of the posterior occipital muscles (rectus capitis posterior major, rectus capitis posterior minor, obliquus capitis inferior) between the left and right sides(P>0.05). Additionally, there were no statistically significant differences in the thickness of the bilateral posterior occipital muscles between the vertigo group and the normal group (P>0.05).
CONCLUSION
The posterior occipital muscles of patients with cervical vertigo are stiffer than those of healthy individuals, while there is no significant difference in muscle thickness between the two groups.
Humans
;
Female
;
Male
;
Elasticity Imaging Techniques/methods*
;
Adult
;
Vertigo/physiopathology*
;
Neck Muscles/physiopathology*
;
Young Adult
2.Left sided sternocleidomastoid interosseous intravascular papillary endothelial hyperplasia: A case report.
Xiaodi XIAO ; Youchen XIA ; Jianying LIU ; Peng FU
Journal of Peking University(Health Sciences) 2025;57(5):1002-1004
Intravascular papillary endothelial hyperplasia (IPEH), also known as Masson tumor, is a rare vascular benign tumor of blood vessels. It may occur in any part of the body, especially the deep dermis and subcutaneous tissue of the head, neck, fingers and trunk. The imaging and histopathology of IPEH are similar to hemangiosarcoma, especially in the case of active vascular endothelial hyperplasia. IPEH is a reactive proliferative lesion of vascular intima. The etiology is still unclear. After some studies showed that IPEH was a benign lesion, few reports on the etiology of it were reported. IPEH is usually limited to the thrombotic vessels or lumens of vascular malformations, usually accompanied by a clear history of trauma. IPEH usually does not cause any symptoms. It looks like a slow-growing lump. Some cases have been reported with pain and swelling. Although IPEH is relatively rare, its accurate diagnosis is crucial because it may be similar to malignant angiogenic lesions in clinical practice. There were few reports of cases related to intravascular papillary endothelial hyperplasia located in the sternocleidomastoid muscle after reviewing the domestic and foreign literature in recent 10 years. This case reports that a young male, who was admitted to the hospital one month after finding a subcutaneous tumor in the left neck. After admittance, relevant preoperative examinations were completed. After multi-disciplinary discussion and elimination of surgical contraindications, a specific surgical plan was formulated. The tumor was removed under local anesthesia on the second day after admission. During the operation, it was found that the tumor was located between the sternocleidomastoid muscle bundles, and it was sent for pathologic examination. Paraffin section pathology was reported after operation. Histological examination showed that the morphology was consistent with vascular endothelial papillary hyperplasia. There were no related surgical complications and recurrence in the 3-month follow-up. The purpose of this paper is to provide clinicians with a certain understanding of this rare disease through the report of this case of IPEH, and to identify it in later clinical work, and at the same time, to avoid confusion with malignant diseases, such as hemangiosarcoma, leading to unnecessary treatment and increase the cost of treatment.
Humans
;
Male
;
Endothelium, Vascular/pathology*
;
Hemangioendothelioma/surgery*
;
Hyperplasia/pathology*
;
Neck Muscles/surgery*
;
Vascular Neoplasms/pathology*
3.The study on the characteristics of active force of neck muscles under rapid braking conditions.
Xiaoxia YUAN ; Fan LI ; Kang LEI ; Qiuhong LIU
Journal of Biomedical Engineering 2023;40(4):676-682
This paper studies the active force characteristics of the neck muscles under the condition of rapid braking, which can provide theoretical support for reducing the neck injury of pilots when carrier-based aircraft blocks the landing. We carried out static loading and real vehicle braking experiments under rapid braking conditions, collected the active contraction force and electromyography (EMG) signals of neck muscles, and analyzed the response characteristics of neck muscle active force response. The results showed that the head and neck forward tilt time was delayed and the amplitude decreased during neck muscle pre-tightening. The duration of the neck in the extreme position decreased, and the recovery towards the seat direction was faster. The EMG signals of trapezius muscle was higher than sternocleidomastoid muscle. This suggests that pilots can reduce neck injury by pre-tightening the neck muscles during actual braking flight. In addition, we can consider the design of relevant fittings for pre-tightening the neck muscles.
Neck Muscles
;
Neck
;
Electromyography
;
Head
4.The application of transcervical non-inflatable endoscopic posterior inferior sternocleidomastoid approach in thyroid surgery.
Yixin JING ; Yiming DING ; Jing ZHOU ; Jun WU ; Hongfei LIU ; Junwei HUANG ; Xiao CHEN ; Zhigang HUANG ; Xiaohong CHEN
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(9):691-694
Objective:To investigate the clinical efficacy and safety of transcervical non-inflatable endoscopic thyroidectomy through the posterior inferior sternocleidomastoid approach. Methods:From December 2022 to May 2023, the clinical data of 35 patients with papillary thyroid carcinoma treated by transcervical non-inflatable endoscopic surgery via posterior inferior sternocleidomastoid approach were retrospectively analyzed. There were 14 males and 21 females, with an average age of 44.7 years. The operation time, bleeding volume, postoperative recovery, complications and follow-up were recorded. Results:All 35 patients successfully completed the surgery, with an average operation time of 4 hours and 7 minutes, an average bleeding volume of 14 ml, and an average postoperative hospital stay of 3.5 days. There were no serious complications and no obvious neck discomfort during postoperative follow-up. Conclusion:Transcervical non-inflatable endoscopic thyroidectomy via posterior inferior sternocleidomastoid approach is safe and effective, with fast postoperative recovery,high appearance satisfaction and good neck comfort.
Female
;
Male
;
Humans
;
Adult
;
Retrospective Studies
;
Neck
;
Neck Muscles/surgery*
;
Thyroid Neoplasms/surgery*
5.Correlation analysis of cervical spine dysfunction, pain and muscle strength in office workers.
Jian Ping LIN ; Shao Qing CHEN ; Ming LI ; Gui Qing XU ; Ting ZHANG ; Shi Zhong WANG
Chinese Journal of Industrial Hygiene and Occupational Diseases 2022;40(3):192-195
Objective: To expore the correlation between neck disability, neck pain and muscle strength in cervical pondylosis of office worker, and to provide scientific basis for the prevention and treatment of cervical spondylosis. Methods: In April 2021 ,234 patients with cervical spondylotic myelopathy treated in the Subsidiary Rehabilitation Hospital of Fujian University of Traditional Chinese Medicine from April 2015 to April 2017 were selected, the correlation between Neck Disability Index (NDI) score, neck pain and muscle strength was analyzed using the Spearman rank correlation method. Mann-Whitney U test was used to compare the difference of maximum muscle strength of isometric contraction. Results: NDI score was negatively correlated with neck flexion, extension, and muscle strength in the left and right flexion directions (r(s)=-0.164, -0.169, -0.222, -0.176, P=0.012, 0.010, 0.001 , 0.007). In mild and moderate functional disorder patients, the muscle strength in flexion, extension and left and right flexion direction was greater, the difference was statistically significant (P <0.01). Conclusion: There is a negative correlation between cervical functional disorder and cervical muscle strength in office workers, suggesting that strengthening cervical muscle strength may be a way to improve cervical spine function.
Cervical Vertebrae
;
Humans
;
Muscle Strength/physiology*
;
Neck Muscles/physiology*
;
Neck Pain/physiopathology*
;
Occupational Diseases/physiopathology*
;
Range of Motion, Articular/physiology*
;
Spondylosis/physiopathology*
6.The Effectiveness of Cystography-Measured Bladder Neck Elevation at Predicting the Return of Continence After Robot-Assisted Radical Prostatectomy
Jung Sik HUH ; Young Joo KIM ; Sung Dae KIM ; Kyung Kgi PARK
International Neurourology Journal 2019;23(3):234-239
PURPOSE: To analyze the clinical parameters correlated with early recovery of urinary continence after radical prostatectomy, with a focus on urethral mobility during pelvic contraction at catheter removal. METHODS: We prospectively analyzed 67 patients who underwent prostatectomy for prostate cancer at Jeju National University Hospital from January 2015 to June 2018. At the time of catheter removal, a cystography was performed in 67 men (median age, 65 years; range, 55–76 years) who had undergone robot-assisted laparoscopic prostatectomy. The vertical length of bladder neck movement between relaxing and contracting the pelvic muscles was measured. The correlation between the rate of continence recovery and the length of urethral movement was also assessed. All participants were divided into 2 groups according to the length of bladder neck elevation. Group 1 had ≥0.6 cm of elevation, while group 2 demonstrated <0.6 cm of elevation. RESULTS: A reverse correlation existed between the length of urethral movement and the recovery rate of urinary continence (r=–0.488, P<0.001). The optimal cutoff value for length of urethral movement was found to be 0.6 cm among patients (area under the curve, 0.703). A statistically significant difference was observed between group 1 (length≥0.6 cm) and group 2 (<0.6 cm) (P<0.05). Multivariate regression analysis showed that urethral movement predicted the postoperative urinary incontinence. CONCLUSIONS: The extent of bladder neck elevation after robot-assisted laparoscopic prostatectomy, which can be easily evaluated using cystography, may be a good predictor of the recovery of urinary continence.
Catheters
;
Humans
;
Male
;
Muscles
;
Neck
;
Prospective Studies
;
Prostatectomy
;
Prostatic Neoplasms
;
Urinary Bladder
;
Urinary Incontinence
7.Comparison of the muscle activity in the normal and forward head postures based on the pressure level during cranio-cervical flexion exercises
Journal of Korean Physical Therapy 2019;31(1):1-6
PURPOSE: This paper proposes proper and effective neck exercises by comparing the deep and superficial cervical flexor muscle activities and thickness according to the pressure level during cranio-cervical flexion exercises between a normal posture group and forward head posture group. METHODS: A total of 20 subjects (8 males and 12 females) without neck pain and disabilities were selected. The subjects' craniovertebral angles were measured; they were divided into a normal posture and a forward head posture group. During cranio-cervical flexion exercises, the thickness of the deep cervical flexor neck muscle and the activity of the surface neck muscles were measured using ultrasound and EMG. RESULTS: The results showed that the thickening of the deep cervical flexor was increased significantly to 28 and 30 mmHg in the forward head posture group. The sternocleidomastoid muscle activity increased significantly to 24, 26, 28, and 30 mmHg in the forward head posture group. The anterior scalene muscle activity increased significantly to 26, 28, and 30mmHg in the forward head posture group. A significant difference of 26, 28, and 30 mmHg in the sternocleidomastoid and anterior scalene muscles was observed between two groups. CONCLUSION: To prevent a forward head posture and maintain proper cervical curve alignment, the use of the superficial cervical flexor muscles must be minimized. In addition, to perform a cranio-cervical flexion exercises to effectively activate the deep cervical flexor muscles, 28 and 30 mmHg for normal posture adults and 28 mmHg for adults with forward head postures are recommended.
Adult
;
Exercise
;
Head
;
Humans
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Male
;
Muscles
;
Neck
;
Neck Muscles
;
Neck Pain
;
Posture
;
Ultrasonography
8.A Complex Suicide by Ligature Strangulation and Hanging Using Two Different Ligatures
Kunasilan SUBRAMANIAM ; Chandroth Navin PANKAJAKSHAN
Korean Journal of Legal Medicine 2019;43(3):106-110
Hanging is the most common method of suicide in Malaysia. However, hanging in combination with suicidal ligature strangulation is uncommon. The victim is a 31-year-old man, with no previous medical or psychiatric disorders. He accomplished self-strangulation using a shoelace and hanging himself with a High-Definition Multimedia Interface cable. Three loops of a shoelace ligature were present around the neck. A single knot was present on the front, and a double knot at the back of the neck. Internal examination of the neck revealed small bilateral hemorrhages of the sternocleidomastoid muscles. No laryngeal cartilage or hyoid bone fractures were observed. No other evidence of injury was noted other than moderate pulmonary edema. The post-mortem toxicology results were negative. The cause of death was ascertained as neck compression due to ligatures. Scene assessment and post-mortem findings concur with suicide. This report describes an unusual case of suicidal ligature strangulation, in combination with hanging using two different ligatures.
Adult
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Cause of Death
;
Hemorrhage
;
Humans
;
Hyoid Bone
;
Laryngeal Cartilages
;
Ligation
;
Malaysia
;
Methods
;
Multimedia
;
Muscles
;
Neck
;
Pulmonary Edema
;
Suicide
;
Toxicology
9.Auto-segmentation of head and neck organs at risk in radiotherapy and its dependence on anatomic similarity
Anantharaman AYYALUSAMY ; Subramani VELLAIYAN ; Shanmuga SUBRAMANIAN ; Arivarasan ILAMURUGU ; Shyama SATPATHY ; Mohammed NAUMAN ; Gowtham KATTA ; Aneesha MADINENI
Radiation Oncology Journal 2019;37(2):134-142
PURPOSE: The aim is to study the dependence of deformable based auto-segmentation of head and neck organs-at-risks (OAR) on anatomy matching for a single atlas based system and generate an acceptable set of contours. METHODS: A sample of ten patients in neutral neck position and three atlas sets consisting of ten patients each in different head and neck positions were utilized to generate three scenarios representing poor, average and perfect anatomy matching respectively and auto-segmentation was carried out for each scenario. Brainstem, larynx, mandible, cervical oesophagus, oral cavity, pharyngeal muscles, parotids, spinal cord, and trachea were the structures selected for the study. Automatic and oncologist reference contours were compared using the dice similarity index (DSI), Hausdroff distance and variation in the centre of mass (COM). RESULTS: The mean DSI scores for brainstem was good irrespective of the anatomy matching scenarios. The scores for mandible, oral cavity, larynx, parotids, spinal cord, and trachea were unacceptable with poor matching but improved with enhanced bony matching whereas cervical oesophagus and pharyngeal muscles had less than acceptable scores for even perfect matching scenario. HD value and variation in COM decreased with better matching for all the structures. CONCLUSION: Improved anatomy matching resulted in better segmentation. At least a similar setup can help generate an acceptable set of automatic contours in systems employing single atlas method. Automatic contours from average matching scenario were acceptable for most structures. Importance should be given to head and neck position during atlas generation for a single atlas based system.
Brain Stem
;
Head and Neck Neoplasms
;
Head
;
Humans
;
Larynx
;
Mandible
;
Methods
;
Mouth
;
Neck
;
Organs at Risk
;
Pharyngeal Muscles
;
Radiotherapy
;
Spinal Cord
;
Trachea
10.Development of a Novel Intraoperative Neuromonitoring System Using an Accelerometer Sensor in Thyroid Surgery: A Porcine Model Study
Eui Suk SUNG ; Jin Choon LEE ; Sung Chan SHIN ; Hyun Keun KWON ; Han Seul NA ; Da Hee PARK ; Seong Wook CHOI ; Jung Hoon RO ; Byung Joo LEE
Clinical and Experimental Otorhinolaryngology 2019;12(4):420-426
OBJECTIVES: The sensitivity and positive predictive value of widely used intraoperative neuromonitoring (IONM) using electromyography (EMG) of the vocalis muscle in thyroid surgery are controversial. Thus, we developed a novel IONM system with an accelerometer sensor that uses the piezoelectric effect instead of EMG to detect laryngeal twitching. The objective of this study was to evaluate the feasibility and safety of this novel IONM system during thyroid surgery in a porcine model. METHODS: We developed an accelerometer sensor that uses the piezoelectric effect to measure laryngeal twitching in three dimensions. This novel accelerometer sensor was placed in the anterior neck skin (transcutaneous) or postcricoid area. Stimulus thresholds, amplitude, and latency of laryngeal twitching measured using the accelerometer sensor were compared to those measured through EMG of the vocalis muscle. RESULTS: The amplitudes of the accelerometer sensor at the anterior neck and postcricoid area were significantly lower than those of EMG because of differences in the measurement method used to evaluate laryngeal movement. However, no significant differences in stimulus thresholds between the EMG endotracheal tube and transcutaneous or postcricoid accelerometer sensors were observed. CONCLUSION: Accelerometer sensors located at the anterior neck or postcricoid area were able to identify laryngeal twitching. The stimulus intensity measured with these sensors was equivalent to that from conventional vocalis EMG. Our novel IONM system with an accelerometer sensor that checks changes in surface acceleration can be an alternative to EMG of the vocalis muscle for IONM in the future.
Acceleration
;
Electromyography
;
Laryngeal Muscles
;
Methods
;
Neck
;
Recurrent Laryngeal Nerve
;
Skin
;
Thyroid Gland
;
Thyroidectomy

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