| Hyoid bone fracture | |
|---|---|
| Specialty | Orthopedics |
The hyoid bone fracture is a very rare fracture of the hyoid bone, accounting for 0.002% of all fractures in humans. It is commonly associated with strangulation 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.
The main symptoms of a hyoid bone fracture include pain when the affected person rotates their neck, trouble swallowing (dysphagia), and painful swallowing (odynophagia). 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. [1]
Neck trauma, commonly by strangulation, athletic activities, and car accidents, is the cause of a hyoid bone fracture. [1] Other causes include violent vomiting, gunshot wounds, and hanging. [2]
A diagnosis can be made using clinical examination, laryngoscope examination, and/or radiographic studies. [1]
Hyoid bone fractures are classified into three different types: [2]
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. [1]
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. [1]
The neck is the part of the body in many vertebrates that connects the head to the torso. It supports the weight of the head and protects the nerves that transmit sensory and motor information between the brain and the rest of the body. Additionally, the neck is highly flexible, allowing the head to turn and move in all directions. Anatomically, the human neck is divided into four compartments: vertebral, visceral, and two vascular compartments. Within these compartments, the neck houses the cervical vertebrae, the cervical portion of the spinal cord, upper parts of the respiratory and digestive tracts, endocrine glands, nerves, arteries and veins. The muscles of the neck, which are separate from the compartments, form the boundaries of the neck triangles.
The hyoid 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 vertebra.
Airway management includes a set of maneuvers and medical procedures performed to prevent and relieve airway obstruction. This ensures an open pathway for gas exchange between a patient's lungs and the atmosphere. This is accomplished by either clearing a previously obstructed airway; or by preventing airway obstruction in cases such as anaphylaxis, the obtunded patient, or medical sedation. Airway obstruction can be caused by the tongue, foreign objects, the tissues of the airway itself, and bodily fluids such as blood and gastric contents (aspiration).
A thyroglossal cyst or thyroglossal duct cyst is a fibrous cyst that forms from a persistent thyroglossal duct. Thyroglossal cysts can be defined as an irregular neck mass or a lump which develops from cells and tissues left over after the formation of the thyroid gland during developmental stages.
Spondylosis is the degeneration of the vertebral column from any cause. In the more narrow sense, it refers to spinal osteoarthritis, the age-related degeneration of the spinal column, which is the most common cause of spondylosis. The degenerative process in osteoarthritis chiefly affects the vertebral bodies, the neural foramina and the facet joints. If severe, it may cause pressure on the spinal cord or nerve roots with subsequent sensory or motor disturbances, such as pain, paresthesia, imbalance, and muscle weakness in the limbs.
Degenerative disc disease (DDD) is a medical condition typically brought on by the aging process in which there are anatomic changes and possibly a loss of function of one or more intervertebral discs of the spine. DDD can take place with or without symptoms, but is typically identified once symptoms arise. The root cause is thought to be loss of soluble proteins within the fluid contained in the disc with resultant reduction of the oncotic pressure, which in turn causes loss of fluid volume. Normal downward forces cause the affected disc to lose height, and the distance between vertebrae is reduced. The anulus fibrosus, the tough outer layers of a disc, also weakens. This loss of height causes laxity of the longitudinal ligaments, which may allow anterior, posterior, or lateral shifting of the vertebral bodies, causing facet joint malalignment and arthritis; scoliosis; cervical hyperlordosis; thoracic hyperkyphosis; lumbar hyperlordosis; narrowing of the space available for the spinal tract within the vertebra ; or narrowing of the space through which a spinal nerve exits with resultant inflammation and impingement of a spinal nerve, causing a radiculopathy.
The platysma muscle is a superficial muscle of the human neck that overlaps the sternocleidomastoid. It covers the anterior surface of the neck superficially. When it contracts, it produces a slight wrinkling of the neck, and a "bowstring" effect on either side of the neck.
The geniohyoid muscle is a narrow paired muscle situated superior to the medial border of the mylohyoid muscle. It is named for its passage from the chin to the hyoid bone.
A spinal disc herniation or simply a disc herniation is an injury to the intervertebral disc between two spinal vertebrae, usually caused by excessive strain or trauma to the spine. It may result in back pain, pain or sensation in different parts of the body, and physical disability. The most conclusive diagnostic tool for disc herniation is MRI, and treatments may range from painkillers to surgery. Protection from disc herniation is best provided by core strength and an awareness of body mechanics including good posture.
A Jefferson fracture is a bone fracture of the anterior and posterior arches of the C1 vertebra, though it may also appear as a three- or two-part fracture. The fracture may result from an axial load on the back of the head or hyperextension of the neck, causing a posterior break, and may be accompanied by a break in other parts of the cervical spine.
Facial trauma, also called maxillofacial trauma, is any physical trauma to the face. Facial trauma can involve soft tissue injuries such as burns, lacerations and bruises, or fractures of the facial bones such as nasal fractures and fractures of the jaw, as well as trauma such as eye injuries. Symptoms are specific to the type of injury; for example, fractures may involve pain, swelling, loss of function, or changes in the shape of facial structures.
Mandibular fracture, also known as fracture of the jaw, is a break through the mandibular bone. In about 60% of cases the break occurs in two places. It may result in a decreased ability to fully open the mouth. Often the teeth will not feel properly aligned or there may be bleeding of the gums. Mandibular fractures occur most commonly among males in their 30s.
Dislocations occur when two bones that originally met at the joint detach. Dislocations should not be confused with subluxation. Subluxation is when the joint is still partially attached to the bone.
Spinal stenosis is an abnormal narrowing of the spinal canal or neural foramen that results in pressure on the spinal cord or nerve roots. Symptoms may include pain, numbness, or weakness in the arms or legs. Symptoms are typically gradual in onset and improve with leaning forward. Severe symptoms may include loss of bladder control, loss of bowel control, or sexual dysfunction.
Ectopic thymus is a condition where thymus tissue is found in an abnormal location (ectopia). It usually does not cause symptoms, but may leads to a mass in the neck that may compress the trachea and the esophagus. It is thought to be the result of either a failure of descent or a failure of involution of normal thymus tissue. It may be diagnosed with radiology, such as an ultrasound or magnetic resonance imaging. If it causes illness, surgery can be used to remove it. Recurrence after surgery is very unlikely.
The submental space is a fascial space of the head and neck. It is a potential space located between the mylohyoid muscle superiorly, the platysma muscle inferiorly, under the chin in the midline. The space coincides with the anatomic region termed the submental triangle, part of the anterior triangle of the neck.
Fascial spaces are potential spaces that exist between the fasciae and underlying organs and other tissues. In health, these spaces do not exist; they are only created by pathology, e.g. the spread of pus or cellulitis in an infection. The fascial spaces can also be opened during the dissection of a cadaver. The fascial spaces are different from the fasciae themselves, which are bands of connective tissue that surround structures, e.g. muscles. The opening of fascial spaces may be facilitated by pathogenic bacterial release of enzymes which cause tissue lysis. The spaces filled with loose areolar connective tissue may also be termed clefts. Other contents such as salivary glands, blood vessels, nerves and lymph nodes are dependent upon the location of the space. Those containing neurovascular tissue may also be termed compartments.
Osteomyelitis of the jaws is osteomyelitis which occurs in the bones of the jaws. Historically, osteomyelitis of the jaws was a common complication of odontogenic infection. Before the antibiotic era, it was frequently a fatal condition.
Hyoid suspension, also known as hyoid myotomy and suspension or hyoid advancement, is a surgical procedure or sleep surgery in which the hyoid bone and its muscle attachments to the tongue and airway are pulled forward with the aim of increasing airway size and improving airway stability in the retrolingual and hypopharyngeal airway. The horseshoe shaped hyoid bone sits directly below the base of tongue with the arms of the bone flanking the airway. Hyoid suspension is typically performed as a treatment for obstructive sleep apnea (OSA). This procedure is frequently performed with a uvulopalatopharyngoplasty (UPPP) which targets sites of obstruction higher in the airway. Typically, a hyoid suspension is considered successful when the patient's apnea-hypopnea index is significantly reduced after surgery.
Cervical Spondylotic Myelopathy (CSM) is a disorder characterised by the age-related deterioration of the cervical spinal cord. Referred to be a range of different but related terms, a global consensus process selected Degenerative Cervical Myelopathy as the new overarching disease term. It is a neurological disorder related to the spinal cord and nerve roots. The severity of CSM is most commonly associated with factors including age, location and extent of spinal cord compression.