Hyoid bone

The hyoid is a small horseshoe-shaped bone in the upper front of the neck, just below the lower jaw. It consists of a central body, greater horns extending to either side, and short lesser horns attached above them. Its native Korean name, meaning “neck horn bone,” also describes a horn-shaped bone in the neck.

Its most distinctive feature is that it does not form a joint with any other bone. It is connected to the lower jaw, skull, and larynx only by ligaments and muscles, so it is quite literally suspended in a network of muscles.

Several muscles come together at this bone.

• Muscles above the hyoid — These connect toward the jaw and root of the tongue and pull the hyoid upward.
• Muscles below the hyoid — These connect toward the larynx, sternum, and shoulder blade and pull the hyoid downward.
• Tongue muscles — The hyoid provides a firm anchor when the tongue moves.

Because the muscles pulling from above and below balance one another, the hyoid acts as a movable anchor, shifting position along with the tongue and larynx. It is involved in swallowing, speaking, and keeping the airway open.

• It rises when you swallow. While swallowing saliva, lightly place your fingers at the front of your neck beneath your jaw. You will feel something firm move upward and forward, then back down. During swallowing, the hyoid and larynx move forward and upward together, opening the passage for food.
• It also moves when you speak and sing. When you produce high or low sounds, the height of the larynx changes, and the hyoid shifts position accordingly.
• You can feel it with gentle pressure. If you gently hold the upper front of your neck between your thumb and index finger, you can feel the horizontally positioned body of the bone. Its shape and position vary slightly from person to person.
• It may come to mind when the front of your neck aches. After looking at your smartphone for a long time or working with your head bent down, you may feel tightness beneath your jaw and at the front of your neck. This is where the muscles around the hyoid described above are located. However, it is difficult to attribute the aching to any one bone, because the tongue, larynx, muscles, nerves, and blood vessels are all close by.

A videofluoroscopic swallowing study, which examines how swallowing takes place, may assess how far and in which direction the hyoid moves during swallowing. This is because its movement serves as a useful marker of the swallowing process. Some studies have also examined how hyoid movement changes after swallowing training.

The hyoid is relatively well protected by the lower jaw and the soft tissues of the neck surrounding it. Fractures are rare injuries, reported mainly in cases involving a strong external force to the front of the neck.

• Try relaxing the front of your neck. Check occasionally whether you are jutting your chin forward or clenching your mouth shut. Resting your tongue against the roof of your mouth while relaxing your jaw helps the area beneath your jaw feel more comfortable.
• Change your posture often. If you have spent a long time with your head bent down in the same position, about once an hour, lift your head, look into the distance, and slowly move your neck. For more on posture, it may help to read about Forward head posture or the Cervical vertebrae.
• Try swallowing slowly and having water with your food. If you sometimes feel as though your throat is blocked when eating quickly, taking smaller bites and chewing and swallowing slowly can make eating more comfortable.

• When pain persists with every swallow or you repeatedly feel that food is getting stuck
• When pain, swelling, or difficulty breathing develops after a hard blow or pressure to the front of the neck
• When you can feel a lump at the front of your neck or your voice remains hoarse

Rather than assuming these changes are due to the hyoid alone, it is best to have the neck as a whole assessed. Consult a healthcare professional.