• Korean Journal of Bronchoesophagology
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• v.14 no.2
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• pp.57-63
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• 2008

Hypopharyngeal perforation secondary to tracheal intubation is rare, but may result in severe airway complications that include retropharyngeal abscess, pneumothorax, pneumonia, mediastinitis and death. The most common site of hypopharyngeal perforation is the pyriform sinus and the region of the cricopharyngeus muscle. We report a 62-year old man with intubation-induced hypopharyngeal injury presenting as deep neck infection. The patient presented with dyspnea and pain on the neck. Neck CT scan identified fluid and air collection on the neck from the hyoid bone to the thoracic inlet level. Despite of delayed diagnosis, we successfully operated him by using strap muscle myofascial transposition flap. The patient was followed up for 3 months without any complications.

• Journal of the Ergonomics Society of Korea
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• v.32 no.6
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• pp.541-547
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• 2013

Objective: The aim of this study is to find the influence on muscle fatigue by changing an angle of neck while Shaker exercise. Background: Shaker exercise is commonly applied to dysphagia patients for strengthen suprahyoid muscle(SHM) and relaxing upper esophageal sphincter. Method: Experiments were conducted by measuring muscle fatigue with surface electromyography(SEMG) in case of neck $15^{\circ}$ and $50^{\circ}$ flexion, in addition to original method. For the study 30 undergraduate students were participated as subjects. Muscle fatigue was measured with variations of median frequency(MF) and median frequency slope(MFS) by attaching SEMG to 3 muscles. At the same time, perceived exertion was measured by using Borg's rating of perceived exertion(RPE). Results: A MF was increased when low angle in SHM, both male and female. It means that muscle fatigue was significantly decreased(p<.05). RPE was significantly increased when low angle(p<.01). Perceived exertion explained 15.2% of the variation of MF in SHM. And regression equation was, MF in SHM = 59.918 + (4,910 * RPE). Conclusion: The outcome shows that it is possible to use the efficient method which makes muscle fatigue decrease by reducing the angle of neck flexion. Application: The results might contribute to develop the effective Shaker exercise method.

• Anatomy and Cell Biology
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• v.56 no.4
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• pp.441-447
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• 2023

One of the suprahyoid muscles is the digastric muscle which comprises anterior and posterior bellies joined by an intermediate tendon. Because of its close relationship with the submandibular gland, lymph nodes, and chief vessels of the neck, detailed knowledge about the morphometry of the digastric muscle is essential. The objective of the current cross-sectional evaluative study is to record morphometry along with the digastric muscle's origin, insertion, and variability. Forty human cadavers (25 males and 15 females) were dissected, and the head and neck regions were studied in detail. The attachment of the digastric muscle anterior belly to the digastric fossa of the mandible was noted, and the distal attachment of the posterior belly to the mastoid notch was traced. The length of the anterior belly from the digastric fossa to its intermediate tendon and the length of the posterior belly from the intermediate tendon to its mastoid attachment were measured. There is a fair correlation between the length of the neck and the length of the anterior and posterior belly. The study also identified two cases of bilateral accessory bellies of the anterior belly of the digastric. Normal morphometric data is provided by this study on details of the digastric muscle. It is significant from a clinical and surgical point of view as the muscle lies in proximity to the important structures of the neck.

• Korean Journal of Head & Neck Oncology
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• v.32 no.2
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• pp.79-83
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• 2016

Chyle fistula is one of the complications of neck dissections. Although immediate surgical repair seems to be the best choice when chyle leakage is observed during the operation, some operators can be embarrassed when chyle leakage is heavy and not controlled during surgery. In this case, chyle leakage was occurred after extensive resection of lymph nodes in left level IV, and was not controlled in any way. The clavicular head of sternocleidomastoid muscle was dissected and inferior-based muscular flap was rotated to cover the suspected region of fistula orifice. Amount of drainage was checked less than 20 ml per day in the following days, and drain tube was taken out on the 3rd postoperative days. We present the technique using the inferior based sternocleidomastoid muscle flap for intraoperative management of chyle leakage not easily controlled.

• Radiation Oncology Journal
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• v.33 no.4
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• pp.344-349
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• 2015

Late complications of head and neck cancer survivors include neck muscle atrophy and soft-tissue fibrosis. We present an autopsy case of neck muscle atrophy and soft-tissue fibrosis (sternocleidomastoid, omohyoid, digastric, sternohyoid, sternothyroid, and platysma muscles) within the radiation field after modified radical neck dissection type I and postoperative radiotherapy for floor of mouth cancer. A 70-year-old man underwent primary tumor resection of the left floor of mouth, left marginal mandibulectomy, left modified radical neck dissection type I, and reconstruction with a radial forearm free flap. The patient received adjuvant radiotherapy. The dose to the primary tumor bed and involved neck nodes was 63 Gy in 35 fractions over 7 weeks. Areas of subclinical disease (left lower neck) received 50 Gy in 25 fractions over 5 weeks. Adjuvant chemotherapy was not administered.

• Journal of International Academy of Physical Therapy Research
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• v.9 no.2
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• pp.1498-1507
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• 2018

The purpose of this study was to examine the immediate effect of neck stabilization exercise and Swiss ball exercise on the recovery from the fatigue of neck muscles induced. The turtleneck posture was set artificially by using Smartphone with healthy adults. Repetitively measured ANOVA was executed to examine the changes in the muscle fatigue of sternocleidomastoid, upper trapezius, and splenius capitis among three-time intervals (at the time of general resting, work and after intervention) in the three intervention groups (neck stabilization exercise group, Swiss ball exercise group, and ordinary rest group). There were no significant differences in the changes of fatigue of sternocleidomastoid muscle among all three intervention groups at the time of general resting, work and after intervention (p>.05). Although there was no significant difference in the changes in the fatigue of upper trapezius and splenius capitis muscles between the intervention groups at the time of general resting and work (p>.05), there was the significant difference between the three intervention groups at the time of work and after intervention (p>.05). This study suggest that Swiss ball exercise is more effective in reducing the muscular fatigue of the neck and shoulder at a turtleneck posture than neck stabilization exercise.

• Journal of the Korean Society of Physical Medicine
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• v.18 no.4
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• pp.145-154
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• 2023

PURPOSE: This study was conducted to investigate the effect of the sling exercise wearing a neck orthosis on the craniovertebral angle, muscle tension, and headaches in adults with a forward head posture and tension headache. METHODS: In this single-blinded, randomized, controlled, comparative study, a total of 22 adults with forward head postures and tension headaches were randomly assigned to the experimental group (sling exercise wearing a neck orthosis, n = 11) or the control group (sling exercise without a neck orthosis, n = 11). All participants undertook the sling exercise program (3×/week for 4 weeks). The craniovertebral angle, muscle tension, and headache were measured before and after the 4-week training. RESULTS: Significant improvements were observed in the craniovertebral angle, muscle tension, and headache in the experimental group (p < .05). This group also showed a larger decrease in the muscle tension and headache (upper trapezius, -4.97 Hz vs -1.70 Hz, p < .05; splenius capitis, -5.44 Hz vs -2.54 Hz, p < .05; headache, -19.73 score vs -14.64 score, p < .05, respectively). CONCLUSION: The sling exercise wearing a neck orthosis could be an effective way to relieve the symptoms caused by a forward head posture. It could also be a more effective way of decreasing muscle tension and headaches than the sling exercise without wearing a neck orthosis.

• Journal of The Korean Society of Integrative Medicine
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• v.9 no.1
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• pp.123-131
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• 2021

Purpose : The time spent using smart devices is constantly increasing, particularly in recent times. Using smart devices for a long time with an incorrect posture may lead to cerebral palsy (CP), instability, and abnormal muscle tone. Therefore, we aimed to investigate the relationships among cervical instability, deep neck flexor (DNF) activity, range of motion (ROM), and muscle tonus. Methods : Fifty subjects with CP participated in this study, and they were physiotherapists at W Hospital in Daejeon. Those who voluntarily participated in the research were selected as candidates who fulfilled the selection criteria. According to an instability test, 25 subjects were assigned to the instability and control groups. All subjects first underwent the instability test to be allocated to the appropriate group. Those in the instability group tested positive on the instability test. The Neck Disability Index (NDI), ROM, muscle tone, and DNF activity were measured to evaluate their relationships. The DNF strength and endurance were measured using a cranio-cervical flexion test. The upper trapezius (UT), sternocleidomastoid (SCM), and suboccipital (SO) muscle tones were measured using a contact soft tissue tone measuring instrument. The statistical significance level was set to .05. Results : There were significant differences in the flexion, extension, and rotation of the cervical ROM (CROM) between the two groups (p<.05). The SCM, UT, and SO muscle tones were significantly different between the two groups (p<.05). The DNF strength and endurance showed a significant difference between the two groups (p<.05). Conclusion : We found that there were significant increases in the CROM and muscle tone and decrease in the DNF strength and endurance in the instability group. This indicated that cervical instability is affected by the DNF strength and endurance. We may recommend DNF exercises in cases of cervical instability in clinical environments.

• The Journal of Korean Physical Therapy
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• v.31 no.1
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• pp.1-6
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• 2019

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.

• PNF and Movement
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• v.15 no.3
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• pp.291-302
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• 2017

Purpose: The purpose of this study was to describe the effects of neck and trunk stabilization exercise on the onset time of trunk muscle contraction in the elderly. Methods: Elderly subjects were divided into 2 groups: a neck and trunk stabilization exercise group (NTSG) and a control group (CG). The NTSG performed both neck and trunk stabilization exercises and the CG performed gait training on a treadmill, at 30 min per session, 3 times per week, over 8 weeks. Surface electromyography was employed to measure the onset times of trunk muscle contractions in the right anterior deltoid, rectus abdominis, external oblique abdominis, internal oblique abdominis, and erector spinae muscles. Results: The NTSG subjects showed earlier and statistically significant onset of contraction in trunk muscles as compared to the CG. Conclusion: The combination of neck and trunk stabilization exercises may more effectively improve the onset of muscle contractions in the elderly than other types of exercise. The present study's findings may be used as basic data for the development of exercise programs suitable to the elderly, specifically for the design of home exercise programs.