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E1670. The Hyoid Bone: The Forgotten Anchor of the Neck
Authors
  1. Justin Costello; University of Utah
  2. Kalen Riley; University of Utah
  3. Yoshimi Anzai; University of Utah
Background
The hyoid bone is a key structure in the neck which serves as both a structural anchor and as an important landmark dividing the neck into suprahyoid and infrahyoid components. The hyoid is a horseshoe shaped bone which is unique in that it does not articulate with any other bones. A number of small muscles in the neck insert on the hyoid bone and play a role in the pharyngeal phase of swallowing. There is also the attachment of the stylohyoid ligament which, when calcified, can cause symptoms of dysphagia. The hyoid bone serves as an important anatomic landmark in discussion of head and neck pathology but is rarely the main focus of discussion.

Educational Goals / Teaching Points
The goal of this presentation is to provide examples of pathologic processes which may be encountered by radiologists involving this often overlooked structure. While there are a few primary processes which can involve the hyoid, the majority of attention will be paid to pathology arising from surrounding structures.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
There are a number of pathologic processes which can involve the hyoid bone on imaging. Differential considerations include trauma, infection, neoplasms, congenital and mechanical abnormalities, and osteoradionecrosis. Representative cases that were selected for inclusion in this exhibit include traumatic injury, invasive local cancer, metastatic disease, osteoradionecrosis, and congenital abnormalities. CT and MRI were the most performed imaging modalities and the most likely to be encountered by other radiologists. CT is the main workhorse of the radiologist in the head and neck, and is utilized in the majority of cases. MRI is also frequently utilized, however, and has a key role to play in the evaluation of malignancy and infection.

Conclusion
The hyoid bone plays an important structural and functional role within the neck. The hyoid can be affected by pathology arising from the surrounding structures and recognition of these processes is important for patient care. CT and MRI are the most utilized imaging modalities for evaluation of these lesions and can define their anatomic origin and extent as well as help narrow the differential diagnosis. Familiarity with both the anatomy and common pathologic processes in the neck is critical for accurate and timely diagnosis of pathology involving the hyoid bone.