The omohyoid sling syndrome

Background: Patients with the omohyoid syndrome present with a transient lo wer neck swelling during swallowing. The mechanism of functional derangemen t has been hypothesized previously but never proven. Our aim is to show how this can be demonstrated real-time. Method and Patients: Five patients were studied. Serial photography, clinic al videography, real-time ultrasonography, and simulated cine mode computed tomography were used. Findings were compared with the normal side. The lit erature was reviewed. Results: Very little literature experience is available. The swelling appea rs when the throat ascends and subsides with its descent in unison with omo hyoid prominence. The sternomastoid is passively tented up by an abnormal u nderlying omohyoid. This latter appears to have lost its restriction to bow string by the retaining deep cervical fascia. Conclusion: The described approach allowed for definite proof of the pathog enetic mechanism, provided a means of diagnosis, and suggested further insi ght into the management of these patients.