Evaluation of Hyoid Bone Fusion Deficiency as a Fracture: A Review

The aim of this review is to raise awareness that delayed fusion between the body of the hyoid bone and the greater horns should not be misinterpreted as a fracture. The hyoid bone is the only bone in the human body that does not articulate with any other bone and, due to its multidirectional mobility, possesses a certain protective capacity against traumatic forces. The junction between the body of the hyoid bone and the greater horns may present as non‑fused, partially fused, or completely fused. However, the number of studies directly addressing the fusion process of the hyoid bone remains limited. Previous literature has reported the mean ages of unilateral and bilateral fusion as 38.25 and 53.16 years in males, and 38.00 and 48.50 years in females, respectively. Another study noted that fusion of the greater horns with the body of the hyoid bone rarely occurs before the age of 35-45 years. Such age‑related delays in fusion increase the risk that non‑fused regions may be misinterpreted as fracture lines or dislocations, particularly in younger individuals. Therefore, especially in individuals under 35 years of age, the wide spectrum of non‑fusion and partial fusion should be carefully considered. Given the limited diagnostic value of conventional radiography, evaluation of suspicious cases should be supported by computed tomography, and advanced imaging modalities should be preferred to achieve an accurate diagnosis. This approach significantly improves diagnostic accuracy in distinguishing true hyoid bone fractures from fusion variants.