PMC4985691_01
Latero-lateral radiograph of the neck: bilateral fracture of the thyrohyoid bones (white arrows). The hyoid bones (1-5) and thyroid cartilage (th) can be identified.
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F1
They revealed subcutaneous air bubbles consistent with subcutaneous emphysema near the larynx and dorsal to the neck, a pneumomediastinum, and bilateral fractures of the thyrohyoid bones (Figures 1 and 2).
Anatomy of the hyoid bone in a canine cadaver (1-5), lateral aspect: (1) Basihyoid, (2) Ceratohyoid, (3) Epihyoid, (4) Stylohyoid, (5) Thyrohyoid, (6) Thyroid cartilage, (7) Sternohyoid muscle, (8) Hyoglossal muscle, and (9) Geniohyoid muscle.
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F2
They revealed subcutaneous air bubbles consistent with subcutaneous emphysema near the larynx and dorsal to the neck, a pneumomediastinum, and bilateral fractures of the thyrohyoid bones (Figures 1 and 2). Further inspection revealed that the hyoepiglotticus muscles were damaged bilaterally, and the basihyoid bone was displaced rostrally due to contraction of the hyoglossus and geniohyoideus muscles (Figure 2).
Intraoperative pictures; ventral approach to the larynx: the head is on the left side of the picture. Basihyoid bone (H) with part of the sternohyoid muscles displaced cranially, cranial rupture of both sternohyoid muscles (S) and separation from the basihyoid bone, tear in the mucosa ventral to the epiglottis, piriform recess is opened (arrow), superficial sphincter colli muscle (SC), epiglottis (E), and thyroid cartilage (T).
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F3
Bilateral thyrohyoid bone fractures could be identified (Figures 3 and 4). The bilateral hyoepiglotticus muscles could not be clearly identified (Figure 3).
Intraoperative pictures; ventral approach to the larynx: the head is on the left side of the picture. Reattachment of the ventral epiglottic mucosa, fracture of the right thyrohyoid bone (white arrow), basihyoid bone (H), thyroid cartilage (T), and sternohyoid muscle (S), the black arrows show the ends of the muscle tissue that were sutured back together.
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F4
Bilateral thyrohyoid bone fractures could be identified (Figures 3 and 4).
Postoperative latero-lateral neck radiograph is showing the bilateral intraosseous wire fixation of the thyrohyoid bone fracture (arrows), feeding tube (F), and tracheostomy tube (T).
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F5
After surgery, latero-lateral cervical radiographs were taken (Figure 5) to confirm the position of the feeding tube in the esophagus, and a neck bandage was applied.
Two-month postoperatively, oblique extended latero-lateral neck radiograph is showing bilateral thyrohyoid bone in presumptive normal anatomic position and intraosseous wire fixation (black arrows). Notice the ossification of laryngeal cartilage area (white arrow).
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F6
Cervical radiographs revealed symmetry of the hyoid bones and laryngeal cartilage ossification (Figure 6).