Hyoid bone

Last revised by Craig Hacking on 14 May 2024

The hyoid bone is a midline "U or horseshoe-shaped" bone that serves as a structural anchor in the mid-neck. It is the only bone in the human body that does not directly articulate with another bone (other than sesamoids). It is a place of convergence of multiple small neck muscles that permit the pharyngeal phase of swallowing. The location of structures in the neck is often described in terms of relation to the hyoid (i.e. suprahyoid neck; infrahyoid neck).

  • location: midline structure located between the mandible and the thyroid cartilage and anterior to the epiglottis at the level of C3/C4

    • the level of the hyoid separates lymph node levels II from III in the lateral neck and levels Ia and VI in the anterior neck

  • articulations: none

  • blood supply: branches of the external carotid artery

  • relations: numerous muscles insert on the hyoid, detailed below

The hyoid bone is located in the mid-neck, above the thyroid cartilage, anterior to the pharynx. It is divided into 5 parts:

  • body with a transverse ridge running along its superior anterior surface and an incomplete vertical ridge in the midline on its superior anterior surface

  • two greater horns or cornua which are long slender and slightly curved projections that project posteriorly

    • the posterior end of the greater horn forms a small tubercle

    • the joint between the greater horn and the hyoid body is cartilaginous and usually ossifies by the 3rd decade

  • two lesser horns or cornua which are short conical projection that project superiorly from the junction of the greater horn and body

    • the joint between the lesser horn and the hyoid body is finrous

    • occasionally a synovial joint exists between the lesser and greater horns that can ossify

Multiple small neck muscles insert onto different parts of the hyoid 4:

Several ligaments also attach to the hyoid:

Branches of the external carotid artery, predominantly the infrahyoid branch of the superior thyroid artery, and branches of the lingual artery.

The position of the hyoid defines a few lymph node levels of the neck:

  • anteriorly: hyoid separates levels Ia (above) from VI (below)

  • laterally: hyoid separates level II from level III

  • asymmetry (common)

  • long slender lesser horns due to fusion with the ossified stylohyoid ligament

  • failure of fusion of the greater horns to the body

  • absent lesser horns

  • inferiorly positioned anterior to the thyroid cartilage

  • pierced by the thyroglossal duct

  • lingula - midline superior projection from the body

  • absent (rare)

The hyoid is the ossified horseshoe-shaped structure just superior to the thyroid cartilage.

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