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E Gehrking

Publications and source records attributed to E Gehrking.

20 records · Page 2Linked to original sources

[Neurovascular infrahyoid myofascial flap. Anatomic-topographic study of innervation and vascular supply].

Fifteen cadavers were examined bilaterally for the topography of the superior thyroid artery and vein an lower cervical ansa as an axial bundle of vessels and nerves for the infrahyoid myofascial flap. Using injections of methylene blue, the vascular territories of the superior thyroid artery were demonstrated. The superior thyroid artery and vein could be found in all cases. This artery was derived in 47% of cases from the external carotid artery, in 30% from the bifurcation and in 23% from the common carotid artery. In 43% of cases the vein flowed to the facial vein and in 37% to the internal jugular vein. In the remaining 20%, several segmental veins were found that flowed separately to the jugular vein. In case of a far caudally situated vascular bundle the radius of rotation was limited in a cranial direction. The voluntary innervation of the muscles of the infrahyoid myofascial flap was derived from the lower cervical ansa. The upper radix of the ansa was found 1 cm in latero-cranial direction to the greater horn of the hyoid bone, where it separated from the hypoglossal nerve. Present findings show that the superior thyroid artery supplies the infrahyoid musculature in its whole extension from the hyoid bone to the sternum. It is therefore possible to develop a myofascial flap of 3.5 cm x 11.5 cm in size, which can be predicted at an upper vascular and neural bundle. Depending on the radius of rotation, defects of the floor of mouth, tongue and oro- and hypopharynx can be covered sufficiently with this neurovascular myofascial flap.

Arteries↗

Electromyography of the infrahyoid muscles: pathological and normal findings.

UNLABELLED: In recent years, the infrahyoid muscles (IHM) have been used by plastic reconstructive surgeons as a neurovascular muscle flap in the neck and mouth region. METHODS: A preoperative electromyographic examination (EMG) of the IHM was performed in 10 patients, of whom 9 suffered from tongue cancer, in order to detect neurogenic lesions caused by possible metastases or lymph nodes. The results were compared to those of 10 healthy controls. RESULTS: The EMG at rest showed no pathological spontaneous activity in any patient. During light voluntary innervation, the motor unit potentials (MUPs) were normal in controls and in patients with normal sonographic images, computertomographic scans, and histologic findings after surgery in the neck region. When metastatic lymph nodes were found on one side of the neck, the number of polyphasic MUPs in the IHM of that side was increased in some cases (n = 6), and normal in others (n = 5). Traumatic or radiogenic lesions clearly resulted in pathological EMG findings (n = 6). A maximal innervation of the IHM was achieved during head bending and jaw opening, there was no activation of the IHM with tongue movements and vice versa. CONCLUSIONS: If the presence of lymph node pathology was demonstrated using imaging techniques, a resulting lesion of the ansa cervicalis can functionally be demonstrated by EMG. In patients without lymph node metastases and without concurrent other lesions in the cervical region, EMG of the IHM seems to give no further clinical information. A clear postoperative functional differentiation of the transplanted IHM and the indigenous tongue muscles is possible.

Adult↗