The sternohyoid inserts via a flat tendinous sheet onto the inferior surface of the hyoid body, providing the inferior attachment of the infrahyoid strap muscles. This insertion is the target in hyoid bone surgery and in laryngeal framework reconstruction.
The sternohyoid hyoid insertion is exposed during total laryngectomy where the infrahyoid muscles are divided at the hyoid. In hyoid bone suspension surgery for obstructive sleep apnoea (hyoid myotomy and suspension), this tendinous insertion is the attachment point advanced anteriorly to enlarge the hypopharyngeal airway. The hyoid insertion is also the reference point for infrahyoid nerve block.
Sternohyoid hyoid insertion division during total laryngectomy to mobilise the larynx, requiring systematic ligation of the infrahyoid vessels accompanying the tendinous insertion.
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