腮腺手术应用胸锁乳突肌瓣转移预防味觉出汗综合征的效果观察

目的 :了解腮腺手术采用胸锁乳突肌瓣转移对减少味觉出汗综合征发生率的作用。方法 :33例腮腺肿瘤患者行腮腺肿块及部分浅叶切除术。其中 15例同期行胸锁乳突肌瓣转移 ,另 18例按常规方法 ,均按期随访 ,且做碘 -淀粉试验检查作客观评价。结果 :经术后 8～ 18个月观察 ,胸锁乳突肌瓣转移组的 15例中碘 -淀汾试验 2例阳性 ,占 13 33% ;常规组 18例中9例阳性 ,占 5 0 % ,两者间存在显著差异 (P <0 0 5 )。结论 :腮腺部分切除术后行胸锁乳突肌瓣转移可明显降低味觉出汗综合征的发生率 ,是有效预防味觉出汗综合征发生的一种简单、实用 ,无严重并发症 ,且明显改善外形的手术方法     

Sonographic appearance of pyomyositis of the sternocleidomastoid muscle: A case report

Pyomyositis in the neck has rarely been described. We present the sonographic findings in a case of pyomyositis of the sternocleidomastoid muscle. A 62‐year‐old man with poorly controlled diabetes presented with an induration of the neck and fever. On gray‐scale sonography, a part of the sternocleidomastoid muscle appeared swollen and contained irregularly shaped hypoechoic areas. Power Doppler imaging showed increased vascularity in the muscle. Sonographic‐guided aspiration confirmed abscesses in the sternocleidomastoid muscle. Surgical drainage was successfully performed along with antibiotic treatment. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 45 :520–523, 2017     

Smart flap of sternocleidomastoid muscle in anterior cervical spine surgery: Surgical anatomical dissection technique

The use of sternocleidomastoid muscle flap has firstly been described in 1909. In spine surgery, it is usually reserved in the cases of revision after anterior cervical spine procedures. The aim of this article is to introduce its usage as prophylactic measure in cases at high risk of iatrogenic fistula formation. The procedure consists of three main steps: sternocleidomastoid isolation, flap design and harvesting, and flap fixation. The use of a surgical anchor allows a better adherence to the plate preventing hematoma formation. The use of SCM smart flap in primary anterior cervical spine surgery as a prophylactic method could be considered a safe and feasible procedure in patients with a high risk of iatrogenic fistulas.     

改良胸锁乳突肌皮瓣在颌面部肿瘤手术中的应用

目的:探讨改良胸锁乳突肌皮瓣修复口腔颌面部肿瘤切除后组织缺损的方法及疗效,总结其临床经验。方法:2008-04—2009-03我科采用改良胸锁乳突肌皮瓣对6例口腔颌面部因肿瘤术后组织大型缺损进行即刻修复,并对疗效进行观察总结。结果:随访6～15个月,6例改良胸锁乳突肌皮瓣全部成活,外观及功能均较满意。结论:改良胸锁乳突肌皮瓣成活率高,能有效保持颈部功能,同时能有效修复口腔颌面部较大面积缺损,操作简单,手术效果明显。     

小儿肌性斜颈早期治疗

目的 提出了小儿肌性斜颈早期手术治疗的一种挑战性做法以防止头面部的偏斜造成不可逆而又无法矫正的并发症.方法 对本院287例斜颈手术患儿进行了临床追踪观察,17例4个月以下婴儿皆行胸锁乳突肌肿块切除术,5个月～14岁270例中,术前243例面部及头颅偏斜畸形,占90%.其中210例进行按摩治疗,41例按摩加牵引治疗.结果 大多数斜颈患儿手术时多足由于康复治疗效果不佳,并已经出现头面偏斜才进行手术治疗,虽然斜颈得到矫正,但头面偏斜将无法改变.婴儿组17例,随访3月～6年,100%恢复正常功能,且无一例出现面部偏斜.结论 新生儿期斜颈早期行肿块切除术,町获最佳的治疗效果.     

针刺下关穴与胸锁乳突肌起止点治疗周围性面瘫伴耳颞神经痛临床研究

目的:观察针刺下关穴与胸锁乳突肌起止点对周围性面瘫(PFP)伴耳颞神经痛患者神经传导功能、血液流变学指标、血浆内皮素水平的影响,并评价临床疗效。方法:选取PFP伴耳颞神经痛患者120例,按随机数字表法分为对照组55例和观察组65例。两组均在常规药物治疗的基础上进行针刺治疗,对照组采用传统针刺疗法,观察组在对照组基础上针刺下关穴与胸锁乳突肌起止点,两组均连续治疗10 d。观察两组患者House-Brackmann(H-B)面神经功能分级、面部残疾指数(FDI)躯体功能评分和社会功能评分、神经传导功能、血液流变学指标、血浆内皮素水平及不良反应情况,并判定临床疗效。结果:治疗后,观察组H-B面神经功能分级情况优于对照组(P<0.05)。两组FDI躯体功能评分较治疗前均提高(P<0.05),且观察组高于对照组(P<0.05);两组FDI社会功能评分较治疗前均下降(P<0.05),且观察组低于对照组(P<0.05)。两组额肌、口轮匝肌、眼轮匝肌、上唇方肌M波波幅较治疗前均升高(P<0.05),且观察组高于对照组(P<0.05);两组上述4个部位的运动潜伏期较治疗前均缩短(P<0.05),且观察组短于对照组(P<0.05)。两组血浆黏度、全血黏度(低切)、红细胞比容、纤维蛋白原水平较治疗前均降低(P<0.05),且观察组低于对照组(P<0.001)。两组血浆内皮素水平较治疗前均下降(P<0.001),且观察组低于对照组(P<0.001)。观察组总有效率高于对照组(P<0.05)。两组治疗期间均未出现明显不良反应。结论:采用针刺下关穴与胸锁乳突肌起止点治疗PFP伴耳颞神经痛可有效改善患者神经传导功能和血液流变学指标,促进其内皮功能重建,且该疗法疗效较好,不良反应少。     

The reliability of assessing sternocleidomastoid muscle length and strength in adults with and without mild neck pain

Background: The sternocleidomastoid (SCM) is an important cervical spine muscle. Weakness of the SCM muscle has been implicated with cervical problems. No studies have examined the reliability of assessing the SCM muscle length or strength. Also no studies exist that have looked to see if imbalances in SCM muscle length or strength exists between the left and right sides in those with and without neck pain. Objective: To determine the reliability of assessing the SCM muscle for length and strength and to see if SCM length could predict SCM strength in those with and without neck pain. Design: Cross-sectional study. Methods: Fifty-one subjects with and without mild neck pain. Analysis: Intratester reliability was assessed for SCM muscle length and SCM muscle strength. Differences in SCM length and strength were examined in those with and without neck pain. Results: Intratester reliability was shown to be excellent (ICC (2,2) > 0.90) for the left and right SCM when assessing muscle length and muscle strength for those with and without neck pain. No differences were noted when comparing left to right SCM between those with and without neck pain regarding muscle length or muscle strength. Neither regression models were able to predict SCM muscle strength from SCM muscle length. Conclusion: SCM muscle length and SCM strength can be reliably assessed using a bubble goniometer and HHD. No differences were found when comparing left to right SCM muscle length or strength in those with or without mild neck pain.     

电击伤所致喉瘘的修复

目的：探讨电击伤所致喉瘘的修复方法。方法：应用胸锁乳突肌皮瓣带蒂移植的方法修复喉瘘,放置喉模防止喉狭窄,恢复喉功能。结果：患者颈部皮损及喉功能恢复良好。结论：利用近处组织瓣修复电击伤,有利于创伤组织的恢复。     

Pseudotumor of Infancy and Congenital Muscular Torticollis: 170 Cases

Objectives To review pseudotumor of infancy (POI) and congenital muscular torticollis (CMT) and to suggest an algorithm for treatment. Study Design Retrospective review of cases from 1962 to 1998 at a tertiary care center. Methods Patients included in this study were 81 boys and 89 girls who had a diagnosis of POI (n = 38) or CMT (n = 132) before 24 months of age. Results For all patients, the mean age at diagnosis was 4 months; 54.1% had the left side of the neck affected, over 90% had a head tilt, and 2.4% had feeding difficulty as a result of the disorder. Plagiocephaly was present in 39.5% of patients with POI and 63.6% of patients with CMT; a neck mass, in 63.2% and 18.2%, respectively; and facial asymmetry, in 7.9% and 15.9%, respectively. All patients had a complete physical examination; 54.1% had plain cervical radiography, 4.1%, computed tomography, and 2.9%, ultrasonography. Passive range of motion was the initial treatment recommended for 65.3% of patients. Conservative treatment failed for 16 patients; subsequently, they had surgical treatment. Follow‐up data were available for 159 patients; 85.5% experienced total resolution and 14.5% experienced subtotal resolution or long‐term abnormality. Conclusions Children diagnosed with POI or CMT should be treated and observed for at least 12 months or until symptoms resolve. If symptoms persist 1 year after diagnosis despite conservative therapy, surgical treatment should be considered. The majority of children with POI or CMT experience total resolution of symptoms.