The hyoid bone fracture is a very rare

fracture Fracture is the separation of an object or material into two or more pieces under the action of stress. The fracture of a solid usually occurs due to the development of certain displacement discontinuity surfaces within the solid. If a displa ...

of the

hyoid bone The hyoid bone (lingual bone or tongue-bone) () is a horseshoe-shaped bone situated in the anterior midline of the neck between the chin and the thyroid cartilage. At rest, it lies between the base of the mandible and the third cervical vertebr ...

, accounting for 0.002% of all fractures in humans. It is commonly associated with

strangulation Strangling is compression of the neck that may lead to unconsciousness or death by causing an increasingly hypoxic state in the brain. Fatal strangling typically occurs in cases of violence, accidents, and is one of two main ways that hanging ...

and rarely occurs in isolation. The fracture may be associated with gunshot injury, car accidents or induced vomiting. In 50% of strangulations and 27% of hangings, hyoid fractures occur.

Signs and symptoms

The main symptoms of a hyoid bone fracture include pain when the affected person rotates their neck, trouble swallowing (

dysphagia Dysphagia is difficulty in swallowing. Although classified under "symptoms and signs" in ICD-10, in some contexts it is classified as a disease#Terminology, condition in its own right. It may be a sensation that suggests difficulty in the passag ...

), and painful swallowing (

odynophagia Odynophagia is pain when swallowing. The pain may be felt in the mouth or throat and can occur with or without difficulty swallowing. The pain may be described as an ache, burning sensation, or occasionally a stabbing pain that radiates to the b ...

). Other symptoms can be crepitus or tenderness over the bone, suffocation when sticking out the tongue, dyspnea, dysphonia, and subcutaneous emphysema. On laryngoscope examination, lacerations on the pharynx, bruises, swelling, and/or hyoid bone fragments can be seen. If the hyoid bone is fractured, there is a high likelihood that the larynx, pharynx, mandible, and/or cervical spine may be injured as well. Common co-occurring injuries include Le Fort III fractures, mandibular or cervical vertebra fractures, and mandibular dislocation.

Causes

File:Hyoid bone - animation.gif, Position of hyoid bone (shown in red) File:Hyoid bone - close-up - animation.gif, Shape of hyoid bone File:Gray186.png, Hyoid bone—anterior surface, enlarged File:Gray1194.png, Anterolateral view of head and neck Neck trauma, commonly by

, athletic activities, and car accidents, is the cause of a hyoid bone fracture. Other causes include violent vomiting, gunshot wounds, and hanging.

Diagnosis

A diagnosis can be made using clinical examination, laryngoscope examination, and/or radiographic studies.

Classification

Hyoid bone fractures are classified into three different types: * Inward compression fractures with outside periosteal tears * Antero-posterior compression fractures with inside periosteal tears * Avulsion fractures

Treatment

Treatment options vary from very conservative to aggressive. Conservative options include rest, observation, pain control, diet changes, use of a nasopharyngeal tube or oropharyngeal tube, and antibiotic therapy. More aggressive options include surgical repair of the hyoid bone and/or tracheotomy. Surgical treatment was used in 10.9% of cases in a 2012 meta-analysis.

Epidemiology

Hyoid bone fractures represent 0.002% of all fractures; they are rare because the hyoid bone is well-protected by its location in the neck behind the mandible and in front of the cervical spine, as well as its mobility. 91.3% of hyoid bone fractures occur in men.

References

External links

{{Medical resources , DiseasesDB = , ICD10 = {{ICD10, S12.8 , ICD9 = {{ICD9, 807.5 , ICDO = , OMIM = , MedlinePlus = , MeSH = , GeneReviewsNBK = , GeneReviewsName = , Orphanet = Bone fractures Forensic pathology