Hyoid bone fracture with pharyngeal lacerations

Four cases of hyoid bone fracture with laceration of the pharynx are presented. The emergency treatment must aim at an exploration of the neck in an attempt to suture the lacerations of the pharyngeal mucosa. The fractured hyoid bone may be left untouched in most cases. The most common causes of fractures of the hyoid bone were previously considered to be violent strangulation and hanging. In the last two decades, however, road accidents seem to have become the most important cause in patients who survive the initial impact of collision. The biodynamics of injury to the pharynx and larynx in road accidents have been adequately described by Nahum and Siegel (1967). The concluded that the driver was the most frequent victim and the steering wheel was the object with which the neck most commonly collides. It is very easy to miss a fractured hyoid bone during the urgent admission of a patient injured in a traffic accident, since the more dramatic injuries are treated first and a treacheostomy is often performed to provide an airway.