Hyoid Bone Fracture in a Patient as a Rare Cause of Persistent Postoperative Dysphagia Following Anterior Cervical Discectomy and Fusion.
Jennifer A Reilly, Brianna N Hebeka, Justin J Park
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Case in brief
A 76-year-old woman developed severe, persistent dysphagia and progressive odynophagia after C3–5 anterior cervical discectomy and fusion. Symptoms worsened despite oral steroids and a modified liquid diet; by postoperative day 14 she could not swallow, had lost 4.5 kg, and had a persistent cough. CT showed a nondisplaced hyoid fracture. She was admitted for intravenous hydration, steroids, and swallow-therapy education; she declined a recommended PEG tube. With conservative management, swallowing improved, with mild dysphagia at 10 weeks and complete symptom resolution at 5 months, when radiographic fusion was confirmed.
What made this case unusual
A nondisplaced hyoid fracture was identified as a contributor to severe, persistent dysphagia after ACDF, an uncommon explanation for this postoperative symptom.
Diagnostic / clinical pearl
When dysphagia after ACDF worsens or fails to improve, consider hyoid fracture; CT can establish the diagnosis.