Hyoid bone tenderness as a clinical indicator of laryngeal pathology

Hyoid bone tenderness is an underemphasized clinical abnormality and is described as discomfort or pain on gentle palpation of the greater cornu. The primary outcome of this study is to assess if there is any association between hyoid tenderness and laryngeal pathology.

This is a retrospective case-control study.

Ninety-four subjects were identified. These were divided into two groups, those with hyoid tenderness and those without hyoid tenderness. Presenting complaints and findings on nasal laryngoscopy were compared to identify any association between hyoid tenderness and laryngeal pathology.

There were a total of 76 (80.9%) female and 18 (19.1%) male patients in the study. Analysis of presenting complaints showed that dysphonia (P < 0.001, odds ratio = 4.82) and neck pain (P = 0.015, odds ratio = 10.9) were significantly associated with hyoid tenderness, more with these symptoms had hyoid tenderness than expected by chance. Findings on nasal laryngoscopy showed a significant association between hyoid tenderness and vocal fold nodules (P < 0.001). Nasopharyngitis (P = 0.065) and tense anterior neck muscles (P = 0.056) were almost significantly associated with hyoid tenderness.

Hyoid tenderness has previously been reported as an early sign in acute epiglottitis. These results indicate that hyoid bone tenderness may be a useful clinical indicator of various other laryngeal pathologies or dysfunctions.