Suprahyoiditis Treatment
Suprahyoiditis (hyoid syndrome) is effectively treated with local injection of corticosteroid combined with local anesthetic into the region of the greater cornu of the hyoid bone. 1
Primary Treatment Approach
- Inject a mixture of depomedrone (methylprednisolone) and 1% lignocaine directly into the painful area at the greater cornu of the hyoid bone. 1
- This injection therapy is highly effective and provides rapid relief for patients experiencing pain on swallowing that radiates to the ear, face, lower jaw, or pharynx. 1
- The underlying pathology is likely tenosynovitis of the intermediate tendon of the digastric muscle, which responds well to corticosteroid injection. 1
Clinical Recognition
- Suspect suprahyoiditis when patients present with localized pain in the hyoid region that worsens with swallowing and may radiate to the ear, face, or lower jaw. 1
- The condition is often missed despite being relatively common and readily treatable. 1
- Physical examination should include palpation of the greater cornu of the hyoid bone to reproduce the pain and confirm the diagnosis. 1
Important Pitfalls to Avoid
- Do not subject patients to unnecessary investigations or surgery before attempting injection therapy, as this simple treatment is highly effective and avoids more invasive interventions. 1
- Failure to recognize this condition leads to prolonged patient suffering and inappropriate diagnostic workup. 1
Anatomical Considerations
- The suprahyoid region contains the submandibular space (including submandibular gland, lymph nodes, and anterior belly of digastric muscle), sublingual space, and the floor of mouth structures. 2
- The digastric muscle's intermediate tendon passes through this region and attaches near the hyoid bone, making it susceptible to inflammatory conditions. 1, 2