Timely and adequate laryngeal elevation along with hyoid bone movement is an essential component of the swallowing movement under normal physiological conditions. The purpose of this study was to verify the reproducibility of using ultrasonography to evaluate hyoid bone displacement during swallowing through the assessment of inter- and intrarater reliability and examine its accuracy by comparing the results with videofluoroscopic swallowing study (VFSS).

The hyoid bone supports the important functions of swallowing and speech. At birth, the hyoid bone consists of a central body and pairs of right and left lesser and greater cornua. Fusion of the greater cornua with the body normally occurs in adulthood, but may not occur at all in some individuals. The aim of this study was to quantify hyoid bone fusion across the lifespan, as well as assess developmental changes in hyoid bone density. Using a computed tomography imaging studies database, 136 hyoid bones (66 male, 70 female, ages 1-to-94) were examined. Fusion was ranked on each side and hyoid bones were classified into one of four fusion categories based on their bilateral ranks: bilateral distant non-fusion, bilateral non-fusion, partial or unilateral fusion, and bilateral fusion. Three-dimensional hyoid bone models were created and used to calculate bone density in Hounsfield units. Results showed a wide range of variability in the timing and degree of hyoid bone fusion, with a trend for bilateral non-fusion to decrease after age 20. Hyoid bone density was significantly lower in adult female scans than adult male scans and decreased with age in adulthood. In sex and age estimation models, bone density was a significant predictor of sex. Both fusion category and bone density were significant predictors of age group for adult females. This study provides a developmental baseline for understanding hyoid bone fusion and bone density in typically developing individuals. Findings have implications for the disciplines of forensics, anatomy, speech pathology, and anthropology.

In this study, micro-CT was used to observe the microscopic anatomy of the hyoid bone, examine the variation of the trabecular bone inside the hyoid bone, and investigate the internal structure of the hyoid bone.A total of 22 hyoid bones were scanned using micro-CT. The changes in the internal bone trabeculae were assessed with 3D reconstructions, and the fine anatomical structure of the hyoid bone was further analyzed.Micro-CT images showed the microstructure of various parts of the hyoid bone. There were significant differences in total volume, bone volume, bone area, bone density, and volume fraction between the body and greater horns of the hyoid bone (P < .05), but no significant differences in the ratio of bone area/volume and bone surface density were found between the body and greater horns of the hyoid bone (P > .05). In addition, significant differences in the trabecular bone measurements, bone trabecular connectivity, and Euler number were found between the body and greater horns of the hyoid bone (P < .05). Other parameters, including bone trabecular thickness, number of trabecular bones, bone trabecular structure model index, and anisotropy of bone trabeculae, did not differ between the body and greater horns of the hyoid bone (P > .05). There was noticeably ossified healing at the joint between the body and greater horns of the hyoid bone.Micro-CT can adequately display the internal structure of the hyoid bone. The identified bone structure may help clarify the physiological function of the hyoid bone. The present findings provide a theoretical basis for further studies aimed at pathological changes due to hyoid injury in clinical and forensic medicine.

This study aimed to examine the relationship between jaw opening force and hyoid bone dynamics and resting position in elderly individuals based on gender.

This systematic review explores studies using biomechanical analysis of hyoid bone displacement in videofluoroscopy of swallowing as a spatial outcome parameter to evaluate intervention effects. Two authors independently carried out the literature search using the electronic databases Embase, PubMed, and Cochrane Library. Differences in their search findings were settled by discussion. The search was limited to publications in the English, German, French, Spanish, or Dutch language. MeSH terms were used, supplemented by free-text words to identify the most recent publications. In addition, reference lists were searched by hand. Only studies using videofluoroscopy to evaluate the biomechanical effects of swallowing interventions in dysphagic subjects were included in the review. While the body of literature on measuring hyoid bone displacement in videofluoroscopy has grown, only 12 studies met the inclusion criteria. Several of the 12 studies had methodological shortcomings. In general, the conclusions could not be compared across the studies because of their heterogeneous designs and outcome measures. Overall, several intervention effect studies reported significant results. In particular, bolus modification and swallowing maneuvers showed a greater range of hyoid bone displacement. In light of this review, further research on hyoid bone displacement as a spatial variable in well-defined patient populations using well-defined videofluoroscopic protocols to measure intervention effects is recommended.

To assess the differences in hyoid bone position in patients with and without temporomandibular joint osteoarthrosis (TMJOA).

The aim of this study is to investigate the relationship between gender-specific and obesity-related airway anatomy in patients with obstructive sleep apnea (OSA) by using cephalometric analyses.

Animal studies suggest a pivotal role of the hyoid bone in obstructive sleep apnea (OSA). We aimed to explore the role of the hyoid bone in humans by testing the hypotheses that muscle paralysis and lung volume (LV) changes displace the hyoid bone position particularly in people with obesity and/or OSA.

A vertebrate skull is composed of many skeletal elements which display enormous diversity of shapes. Cranial bone formation embodies a multitude of processes, i.e., epithelial-mesenchymal induction, mesenchymal condensation, and endochondral or intramembranous ossification. Molecular pathways determining complex architecture and growth of the cranial skeleton during embryogenesis are poorly understood. Here, we present a model of the hyoid apparatus development in Wnt1-Cre2-induced Meis2 conditional knock-out (cKO) mice. Meis2 cKO embryos develop an aberrant hyoid apparatus-a complete skeletal chain from the base of the neurocranium to lesser horns of the hyoid, resembling extreme human pathologies of the hyoid-larynx region. We examined key stages of hyoid skeletogenesis to obtain a complex image of the hyoid apparatus formation. Lack of Meis2 resulted in ectopic loci of mesenchymal condensations, ectopic cartilage and bone formation, disinhibition of skeletogenesis, and elevated proliferation of cartilage precursors. We presume that all these mechanisms contribute to formation of the aberrant skeletal chain in the hyoid region. Moreover, Meis2 cKO embryos exhibit severely reduced expression of PBX1 and HAND2 in the hyoid region. Altogether, MEIS2 in conjunction with PBX1 and HAND2 affects mesenchymal condensation, specification and proliferation of cartilage precursors to ensure development of the anatomically correct hyoid apparatus.

The primary aim of this study was to evaluate the dentoalveolar, skeletal, pharyngeal airway, cervical posture, hyoid bone position, and soft palate effects of the Myobrace and Twin-block appliances. The second was to compare them in terms of ease of use by assessing the factors that may influence patient compliance.

To assess the position and movements of the hyoid bone during deglutition in patients with open bite.

This study investigated the position of the hyoid bone and its relationship with airway dimensions in different skeletal malocclusion classes using cone-beam computed tomography (CBCT).

The aim of the study was to analyze the morphology and position of the tongue and hyoid bone in skeletal Class II patients with different vertical growth patterns by cone beam computed tomography in comparison to skeletal Class I patients.

Woodpeckers avoid brain injury while they peck at trees up to 20Hz with speeds up to 7m/s, undergoing decelerations up to 1200g. Along with the head, beak and neck, the hyoid apparatus (tongue bone and associated soft tissues) is subjected to these high impact forces. The shape of the hyoid apparatus is unusual in woodpeckers and its structure and mechanical properties have not been reported in detail. High-resolution X-ray micro-computed tomography and scanning electron microscopy with energy dispersive X-ray spectroscopy were performed and correlated with nanoindentation mapping. The hyoid apparatus has four distinct bone sections, with three joints between these sections. Nanoindentation results on cross-sectional regions of each bone reveal a previously unreported structure consisting of a stiff core and outer, more compliant shell with moduli of up to 27.4GPa and 8.5GPa, respectively. The bending resistance is low at the posterior section of the hyoid bones, indicating that this region has a high degree of flexibility to absorb impact. These new structural findings can be applied to further studies on the energy dissipation of the woodpecker during its drumming behavior, and may have implications for the design of engineered impact-absorbing structures.

Identification of prognostic factors for swallowing recovery in patients with post-stroke dysphagia is crucial for determining therapeutic strategies. We aimed at exploring hyoid kinematic features of poor swallowing prognosis in patients with post-stroke dysphagia. Of 122 patients who experienced dysphagia following ischemic stroke, 18 with poor prognosis, and 18 age- and sex-matched patients with good prognosis were selected and retrospectively reviewed. Positional data of the hyoid bone during swallowing were obtained from the initial videofluoroscopic swallowing study after stroke onset. Normalized hyoid profiles of displacement/velocity and direction angle were analyzed using functional regression analysis, and maximal or mean values were compared between the good and poor prognosis patient groups. Kinematic analysis showed that maximal horizontal displacement (P = 0.031) and velocity (P = 0.034) in forward hyoid motions were significantly reduced in patients with poor prognosis compared to those with good prognosis. Mean direction angle for the initial swallowing phase was significantly lower in patients with poor prognosis than in those with good prognosis (P = 0.0498). Our study revealed that reduced horizontal forward and altered initial backward motions of the hyoid bone during swallowing can be novel kinematic features indicating poor swallowing prognosis in patients with post-stroke dysphagia.

Phenotypic robustness requires a process of developmental buffering that is largely not understood, but which can be disrupted by mutations. Here we show that in mef2ca(b1086) loss of function mutant embryos and early larvae, development of craniofacial hyoid bones, the opercle (Op) and branchiostegal ray (BR), becomes remarkably unstable; the large magnitude of the instability serves as a positive attribute to learn about features of this developmental buffering. The OpBR mutant phenotype variably includes bone expansion and fusion, Op duplication, and BR homeosis. Formation of a novel bone strut, or a bone bridge connecting the Op and BR together occurs frequently. We find no evidence that the phenotypic stability in the wild type is provided by redundancy between mef2ca and its co-ortholog mef2cb, or that it is related to the selector (homeotic) gene function of mef2ca. Changes in dorsal-ventral patterning of the hyoid arch also might not contribute to phenotypic instability in mutants. However, subsequent development of the bone lineage itself, including osteoblast differentiation and morphogenetic outgrowth, shows marked variation. Hence, steps along the developmental trajectory appear differentially sensitive to the loss of buffering, providing focus for the future study.

Background: Detailed radiological evaluation of the normal hyoid apparatus by computed tomography (CT) has not yet been conducted. Thus, it is unclear what type of junction connects the different parts of the equine hyoid apparatus. Objectives: To describe the normal CT anatomy of the equine hyoid apparatus, and to determine the junction type that connects the different parts of the hyoid apparatus. Study Design: Combination of retrospective study and prospective cadaver study. Methods: The medical records of horses that underwent head CT scans from 2009 to 2018 were retrieved. Inclusion criteria for the CT scans were visibility of at least two of the four junctions of the hyoid apparatus. CT images were analyzed in three different planes. Additionally, 10 cadaver heads were processed using CT, micro-CT of selected joints, and histology of all joints. Results: CT scans of 200 horses fulfilled the inclusion criteria. The tympanohyoid cartilage consisted of hyaline cartilage. Areas of mineralization within the cartilage were visible on CT scans as early as 2 years of age. The epihyoid was not fused with the stylohyoid in one-third of the horses. All horses younger than 2.5 years showed three ossification centers of the basihyoid, and all horses younger than 1.5 years had a non-fullydeveloped lingual process. In total, 10 of 11 horses between 1.5 and 3 years had separate ossification centers of the lingual process. We found a synchondrosis between the styloid process and the stylohyoid bone. The basihyoid and thyrohyoid, as well as the stylohyoid and epiyhoid were connected by a synostosis in two-thirds of the horses. The remaining parts were connected to one another by synovial joints. Main limitations: The junctions studied by histologic examination were from older horses, therefore growing patterns of different bones could not be totally clarified. Conclusion: The temporohyoid joint is a synchondrosis. The epihyoid is an ossification center of the stylohyoid and fuses with the stylohyoid in two-thirds of horses. The lingual process has a separate ossification center.

The temporomandibular joint disorder (TMD) is a syndrome that affects the masticatory muscles and temporomandibular joint (TMJ). Its pathophysiology is not yet fully known. Cephalometric analysis is used for routine evaluation regarding orthodontic treatment and other purposes. The aim of this study was to assess if using cephalometric analysis and TMJ conservative therapy to evaluate the hyoid bone position and the cervical posture reduced symptoms in adults with TMDs compared to no intervention. The authors conducted a systematic review of the literature (PubMed, Cochrane, Web of Science, Scopus, and Embase) for clinical studies of TMDs with conservative treatment and lateral cephalometric analysis of the hyoid and cervical posture. To assess the risk of bias for non-randomized clinical trials ROBINS-I tool was used. Out of 137 studies found, 6 remained to be included. Most of them found a link between TMD and lateral cephalometric analysis, but there was a high risk of bias. This review found a possible link between TMDs, the neck and cervical posture. There is a benefit reported regarding the use of the lateral cephalometry as a treatment, but more extensive prospective randomized clinical trials are necessary to be able to draw definitive conclusions.

Point of care ultrasound has the potential to become reliable airway assessment tool by accurate prediction of difficult laryngoscopy. We aimed to determine the feasibility of ultrasound in preoperative airway assessment.

As common clinical screening tests cannot effectively predict a difficult airway, and unanticipated difficult laryngoscopy remains a challenge for physicians. We herein used ultrasound to develop some point-of-care predictors for difficult laryngoscopy.