Dr. Google Can’t Answer 🤔 Hyoid Bone and Ligaments

Hello all, looking for someone with experience or knowledge of how this works…

I have read on here some horror stories about disturbance of hyoid bone after ES surgery. I thought that the hyoid bone did not need the ligaments to stay in place? Now I am learning that the hyoid bone DOES need the ligament to hold.

A surgeon I consulted with said he would remove the calcified styloid process and just let the ligaments hang down….

Is this what is common for ES surgery?

How then does the hyoid bone actually stay in place? Dr. Google says the ligament and muscles are what keep the hyoid bone in place.

Please and thank you!

The stylo-hyoid ligaments have to be detached from the styloid to be able to remove it, that’s standard especially if it’s shortened right back to the skull base. The styloid can’t be removed without taking the ligaments off it, so they would always be left loose, & just any calcified sections removed. I can honestly say I’ve never noticed any difference with swallowing, or the hyoid being disturbed since surgery. There has been occasionally a member who has found the hyoid feels off after surgery, but that can often be when one side has been operated on, and the other side ligament is calcified & more rigid, so that might pull the hyoid slightly- the styloid to stylo-hyoid ligament to hyoid, hyoid to other side ligament to other side styloid is like a chain, so removing one side if the other side is a bit rigid can cause a bit of an issue until the second side is removed. Does that make sense?
The hyoid does have other muscles and ligaments attached to it which will help keep it in place; the stylo-hyoid isn’t the only thing holding it, it’s also held by the Thyrohyoid membrane , the Hyoepiglottic ligament, and the Sternohyoid, Mylohyoid, & Omohyoid muscles.

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Wow, Jules! This is amazingly thorough. Thank you so much! Just wanted to make sure I would not be creating another problem for myself. You also confirmed for me that getting both styloid’s removed (even if not necessarily at the same time) will help feel more balanced. I only want to deal with a surgeon who agrees with this philosophy.


I asked Dr. Hepworth what happens to the ligaments removed when the styloid is taken out. He said they are just left there and the body reabsorbs them.
I asked if there were any issues with them being left and he said not that he knows of.
I know it sounds crazy to leave dangling parts in there but I can say, like Jules, that after my left side was done I don’t notice anything off.


@juliezuber , thank you for asking! That is great news :blush:

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