Fractures of the hyoid bone complicating facial fracture: a case report

doi:10.1016/0007-117X(73)90025-5

British Journal of Oral Surgery

Volume 11, Issue 2, November 1973, Pages 106-109

British Journal of O...

https://doi.org/10.1016/0007-117X(73)90025-5 Get rights and content

Abstract

A case is reported of a 16-year-old youth who sustained a bilateral fracture of the lesser cornua of the hyoid bone and bilateral fractures of the mandible, complicated by the presence of a large mandibular cyst, following an assault. The importance of excluding the possibility of fractures of the hyoid bone by clinical and radiographic examination in patients with multiple injuries is stressed, and the clinical findings in such a case are described.

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There are more references available in the full text version of this article.

Cited by (15)

Analysis of perimortem trauma in hanged individuals from the Lisbon Identified Skeletal Collection
2021, Legal Medicine
Citation Excerpt :
However, lower incidences of hyoid fractures were noted by Green et al. [14] and Mukhopadhyay [15], 10 out of 40 individuals, and 16 out of 100 hanging cases, respectively. Not only hanging can lead to trauma of the hyoid bone, but it can also originate from blows or strangulation [28]. Thus, the existence of trauma on the hyoid bone alone is not a sufficient sign of hanging.
Hanging consists of the external pressure of the neck by a ligature through suspension of the body. It may cause death by asphyxiation, vascular change, cerebral ischaemia, anoxia or bone trauma. Skeletal trauma by hanging occurs predominantly at the axis, but may likewise take place at the cranial base, other upper cervical vertebrae, and hyoid bone. Six individuals from the Lisbon Identified Skeletal Collection, whose cause of death was by hanging, were macroscopically analyzed for perimortem trauma at the cranium and cervical area. Only one female individual of 53 years exhibited perimortem fractures. The trauma observed at the sixth cervical vertebra and the cranium was inconsistent with the fracture pattern expected for hanging. The individual also had a craniotomy, suggesting the perimortem blunt trauma arose on the autopsy procedure, which was confirmed by the medical-legal report. Hanging not always results in skeleton trauma as methods of hanging can differ in drop length, knot position, and ligature material. This study emphasizes the difficulty in inferring death by hanging in non-identified skeletons, particularly in suicides.
Hyoid fracture concomitant with comminuted mandibular fracture: A case report
2021, Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology
Citation Excerpt :
The patient has followed a favorable course for both fractures with no sequelae noted (Fig. 3C, D). Hyoid fracture is a rare type of maxillofacial trauma, and we were only able to locate 11 such cases in the literature [2,5–13]. Most of these cases involved direct fractures caused by traffic accidents [2,5,8–12].
In rare cases, traumatic injury of the maxillofacial area may cause a hyoid fracture. We treated a rare case of hyoid fracture accompanying comminuted mandibular fracture.
A 71-year-old man who fell from scaffolding at a height of 2 m was transported by ambulance to our facility. The patient was diagnosed with mandibular comminuted fracture and hyoid fracture based on computed tomography imaging. Open reduction and internal fixation were performed on the mandibular comminuted fracture. We selected conservative treatment for the hyoid fracture as it was only causing mild odynophagia and laryngeal edema. The patient did not exhibit any dyspnea, subcutaneous emphysema, or bloody sputum. On day 4 of hospitalization, the laryngeal edema and odynophagia had improved. On day 28 of hospitalization, the patient was discharged after progressing favorably postoperatively. At 6 months postoperatively, computed tomography images showed that although the greater horn of hyoid bone had not returned to its proper position, deviation had improved compared to that before surgery, and continuity was confirmed with the cortical bone. Repositioning and osteosynthesis of the mandibular fracture were favorable.
In cases of maxillofacial trauma exhibiting laryngeal trauma injuries such as hyoid fracture, even mild cases have a risk of developing serious dyspnea over time. Physicians should consider carefully monitoring the course of such cases over 48–72 h. The possibility of relatively rare concomitant injuries such as hyoid fracture needs to be taken into account when diagnosing and treating maxillofacial trauma cases.
Concurrent hyoid bone fracture associated with multiple facial fractures secondary to assault: Case report and review of literature
2019, Oral and Maxillofacial Surgery Cases
Citation Excerpt :
Comprehensive physical exam, plain film imaging, CT scans, laryngoscopy, and Valsalva maneuver are all methods utilized to evaluate for any hyoid bone and/or laryngeal injuries [9,28,29]. Dysphagia is another indication of possible hyoid bone fracture [1,2,4,5,11,12,16–18]. The majority of hyoid bone fractures are treated conservatively [8].
Hyoid bone fractures are rarely reported as an isolated entity due to the infrequent occurrence accounting for only 0.002% of all head and neck fractures and 1.15 as the highest incidence. Strangulation remains the most common cause of isolated hyoid bone fractures with an incidence of 27–50%. However, blunt trauma, motor vehicle crash, sport related injuries, falls, assaults, and gunshot wounds are additional documented causes of hyoid bone fractures.
A 23-year-old male who was assaulted to the face. He complained of pain to the face and neck, sore throat, dysphagia and changes in speech. The face and neck CT scans revealed multiple facial fractures along with a hyoid bone fracture. Patient was admitted to for observation and close monitoring for airway protection until the mandible and hyoid bone fractures were treated. ORIF of the mandibular fractures took place; we elected to treat the hyoid bone fracture conservatively as it was asymptomatic. The patient's hospital course was unremarkable.
56 articles were reviewed from 1949 to 2017, which revealed that isolated hyoid bone fractures and hyoid bone fractures associated with other facial fractures are very rare. Hyoid bone fractures due to direct trauma, road traffic accidents, falls, assault and gunshot wounds are more common in males than females. However, in strangulation and suicidal hanging, the incidence is higher in females than males. Multiple methods can be used to evaluate the hyoid bone fractures. The majority of hyoid bone fractures are treated conservatively
Delayed carotid dissection following lower lip revascularization in the setting of hyoid fracture - A case report and review of the literature
2016, Journal of Oral and Maxillofacial Surgery
Citation Excerpt :
In this case, the patient presented with a hyoid bone fracture, presumably from hyperextension of the neck during her initial trauma. Hyoid fractures are traditionally associated with cases of asphyxiation caused by strangulation or hanging.18 In the contemporary literature, the most common causes are motor vehicle accidents and blunt trauma.19
Traumatic injuries to the lip are common, but injuries that require revascularization of the lower lip are infrequent and pose a major challenge to the reconstructive surgeon. This report describes the case of a 53-year-old woman who sustained a lower lip avulsion injury, a comminuted mandibular parasymphyseal fracture, and a hyoid bone fracture secondary to a bicycle accident. Trauma workup included computed tomographic angiography of the head and neck, which did not show vascular injury. Despite successful revascularization of the lower lip, on postoperative day 11 the patient developed a large internal carotid artery dissection and middle cerebral artery stroke. This case highlights the importance of careful postoperative monitoring after high-energy facial trauma, particularly in the setting of vascular and bony injuries.
Isolated hyoid bone fracture. Review of an unusual entity
2005, International Journal of Oral and Maxillofacial Surgery
Fractures of hyoid bone resulting from trauma other than strangulation are very rare, isolated hyoid bone fractures are even rarer, and occur more frequently in young individuals, and in men more than in women. A comprehensive review of the world literature, also two rare cases of isolated hyoid bone fractures induced by direct trauma onto the anterior neck are presented. Additionally, a table summarizing 31 cases from 1954 to 2003, is included. Mechanism of injury, diagnosis, complications, prognosis, and treatment are discussed.
An isolated hyoid fracture secondary to sport injury: A case report and review of literature
2005, International Journal of Pediatric Otorhinolaryngology
A 16-year-old boy sustained a fracture of the hyoid bone following closed neck injury from a hockey puck. Though commonly occurring in association of other fractures of the laryngeal skeleton, the fracture was isolated and a comprehensive evaluation implicated it solely for the clinical picture. Our review of the English literature displays the diversity of opinion on classification and treatment. It also indicates, however, that hyoid fractures are usually managed successfully with minimum intervention as indeed our case was.

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Fractures of the hyoid bone complicating facial fracture: a case report

Abstract

The Lancet

The Journal of Trauma

Journal of Oral Surgery