Learning Objectives

By the end of this section, the learner should be able to:

• Describe the anatomical position and structure of the hyoid bone
• Identify the major components of the hyoid bone
• List the muscular and ligamentous attachments of the hyoid bone
• Explain the functional significance of the hyoid bone
• Apply anatomical knowledge to relevant clinical scenarios

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Overview

The hyoid bone is a U-shaped structure located in the anterior neck, lying at approximately the level of the C3 vertebra. It is situated at the base of the mandible and serves as an important anchoring point for muscles of the tongue, floor of the mouth, pharynx, and larynx.

Unlike most bones in the skeleton, the hyoid does not articulate with any other bone. Instead, it is suspended in position by surrounding muscles and ligaments, allowing it to play a key role in swallowing, speech, and airway maintenance.

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Structure

The hyoid bone consists of three main components:

Body

• The central portion of the hyoid
• Has a convex anterior surface and a concave posterior surface
• Provides attachment for several suprahyoid and infrahyoid muscles

Greater Horns (Cornua)

• Project posterolaterally from each side of the body
• Extend in a posterior, superior, and lateral direction
• Serve as attachment sites for numerous muscles of the neck and pharynx

Lesser Horns (Cornua)

• Small, conical projections arising from the junction of the body and greater horns
• Project superoposteriorly toward the styloid process of the temporal bone
• Provide an attachment for the stylohyoid ligament

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Muscular Attachments

The hyoid bone acts as a central anchoring structure for muscles involved in mastication, swallowing, phonation, and respiration.

Suprahyoid Muscles

These muscles elevate the hyoid during swallowing:

• Digastric
• Stylohyoid
• Mylohyoid
• Geniohyoid

Infrahyoid Muscles

These muscles depress and stabilise the hyoid:

• Sternohyoid
• Omohyoid
• Thyrohyoid

Muscles of the Tongue and Pharynx

• Genioglossus
• Hyoglossus
• Middle pharyngeal constrictor

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Ligamentous Attachments

Several ligaments help maintain the position of the hyoid within the neck:

• Stylohyoid ligament
  • Extends from the styloid process of the temporal bone to the lesser horn
• Thyrohyoid membrane
  • Connects the superior border of the thyroid cartilage to the posterior surface and greater horns of the hyoid
• Hyoepiglottic ligament
  • Attaches the hyoid bone to the anterior surface of the epiglottis

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Activity

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Clinical Relevance

Fracture of the Hyoid Bone

The hyoid bone is well protected by the mandible anteriorly and the cervical spine posteriorly, making fractures relatively uncommon.

However, fractures of the hyoid are classically associated with manual strangulation and are identified in approximately one-third of strangulation-related homicides, making them an important forensic finding.

Traumatic fractures may also occur and can present with:

• Pain on speaking
• Odynophagia (painful swallowing)
• Dyspnoea (difficulty breathing)

Prompt evaluation is essential due to the risk of airway compromise.

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