CBCT showing crooked hyoid

I had a CBCT a couple days ago to evaluate a tooth (it ended up needing extracted). I’ve already been diagnosed with hyoid bone syndrome…elongated right greater cornu pressing on the cervical spine.

Interesting, I looked at my CBCT and the hyoid looks crooked/displaced. Is this a problem?
![Screen Shot 2022-05-28 at 8.52.32 AM|485x500](upload://lk


Interesting to see really. I assume it could be why the one hyoid horn ended up in between the carotid artery and other side ended up elongated touching your vertebrae. May be you should show it to the Surgeon to see overall shape of it

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The crooked hyoid is definitely problematic.

Do you have swallowing problems I.e. choking easily when drinking or swallowing food? (sorry, I’ve forgotten if you mentioned that).

Yes, I do.

Makes perfect sense. I hope the surgery allows the hyoid to level out & swallowing is no longer a problem for you! Maybe ask about that, too i.e. can Dr DeSilva level out the hyoid & somehow stabilize it in a correct position after he removes the greater horn.

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My concern is that if Dr. deSilva only removes the right greater cornu, the remaining hyoid will still be displaced due to the left greater cornu going through the carotid bifurcation potentially causing issues.

That is something to address pre-op. As @KoolDude suggested, take in the 3D image(s) where the carotid issue is visible & have a discussion about it. Ask if he’ll please check up on that situation & ask what’ll he’ll do if he finds it is a problem. You need to know clearly what he’ll do during surgery & what to expect during recovery & beyond i.e. will changing the hyoid so drastically leave you w/ any long-term difficulties especially swallowing but also pain, muscle tension in the area, etc.

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I agree with you. I’ve already showed him multiple images of this area and he said the left side “wasn’t a problem”. About the only thing I can do is to ask him to go ahead and remove the left side. However, he removed the WHOLE greater cornu, as opposed to just shaving a small portion of the bone…which honestly scares the heck out of me. Just looking at the orientation of the hyoid, it’s easy to see why my supra-hyoid muscles are incredibly tight. The left side of the hyoid bone hangs downward a lot!


I still haven’t ruled out having surgery with Dr. Gillespie. I meet with him later this week to discuss things further.

I’m glad you’re leaving your options open. My best advice is to compile a list of questions for both doctors which, for example, entails (not necessarily in this order):

  1. surgical approach i.e. full removal of greater horn vs shaving it to a more normal size
  2. whether or not stabilization of your hyoid is possible i.e. returning it to a neutral position & getting it to stay there
  3. situation w/ the carotid artery vs hyoid
  4. ultimate expected long term outcome i.e. improved swallowing & reduction of other symptoms
  5. number of surgeries of this type has he done

Of course, you should add other questions you have.

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