At surgery, the strap muscles
were extremely adherent to the underlying thyroid, and the normal tissue planes were difficult to identify.
A couple of strap muscles
, the zygomatic minor, the contempt muscle, (which curls the lip) and the zygomatic major, the laughter muscle (which raises the corners of the mouth up and out) are attached, running from the cheekbone beneath the outer corner of the eye to the side of the upper lip.
The position of the schwannoma between the strap muscles
was consistent of the nerve of origin being a branch of the ansa cervicalis.
The skin incision is carried down across the strap muscles
and, if necessary, through the medial portion of the sternocleidomastoid muscle.
Computed tomography (CT) of the neck demonstrated a cystic structure below the strap muscles (figure 2).
On all radiologic images, a thyroglossal duct cyst appears as a cyst-like mass either at the level of the hyoid bone or inside the strap muscles.
The operative field is more extensive than that achieved with other approaches; it extends from the cerebellar hemisphere to the extradural ventral upper cervical spine, and it provides access to tissue outside the spinal canal, such as the ventral strap muscles
Becker et al reported that the most common CT findings in CCNF were the thickening and infiltration of subcutaneous tissues, fluid collection in multiple neck compartments, and diffuse enhancement and thickening of the cervical fascia, platysma, and sternocleidomastoid and strap muscles
Four of these 14 tumors (29%) were located in the head and neck region--one in the pterygoid area at the level of the maxillary tuberosity, one under the carotid bifurcation, one beneath the strap muscles
, and one in the supraclavicular area.
The strap muscles
were closed at the midline, and the skin was closed after the subcutaneous space was drained.
The midline is incised and the strap muscles
Furthermore, the cervical approach commonly used for the treatment of external laryngoceles can disrupt the normal function of the strap muscles
, which are important for tone generation.