Gram Research analysis of a 2026 case report found that a broken hyoid bone may be a rare cause of severe, long-lasting trouble swallowing after neck spine surgery. In the reported patient, a CT scan confirmed the fracture, and swallowing fully recovered within five months. Doctors should consider this injury when swallowing problems worsen or do not improve.
According to research reviewed by Gram, a broken hyoid bone, the small U-shaped bone in the neck that helps move the tongue and throat during swallowing, may be a rare reason some people struggle to swallow for months after neck surgery. This case report describes a 76-year-old woman who had surgery on her neck spine. Her swallowing grew worse over two weeks, she lost about 10 pounds, and a CT scan revealed a small, stable fracture of the hyoid bone. She declined a feeding tube and recovered with supportive care, reaching complete recovery by five months. Because this report covers only one patient, it cannot show how common this problem is. Still, it suggests doctors should consider a hyoid fracture when swallowing problems are severe or do not improve, and that CT imaging can help confirm the diagnosis.
Key Statistics
A 2026 case report published in The American Journal of Case Reports described a 76-year-old woman whose swallowing problems lasted for months after neck spine surgery, with a broken hyoid bone identified on CT scan.
In the 2026 case report, the patient lost about 4.5 kilograms (roughly 10 pounds) by postoperative day 14 and fully recovered her swallowing by five months, with follow-up imaging confirming the neck bones had fused.
The Quick Take
- What they studied: The researchers wanted to know whether a broken hyoid bone could explain severe swallowing problems that lasted long after a common type of neck surgery.
- Who participated: One woman, age 76, who had surgery on three neck spine levels (C3 to C5) to treat a damaged disc and nerve pressure. She had severe trouble swallowing that did not get better with early treatment.
- Key finding: A CT scan showed a small hyoid bone fracture that was not moving out of place. With supportive care, her swallowing improved gradually, showed mild trouble on a swallow test at 10 weeks, and fully resolved by 5 months. Because this is one patient, the result shows what happened in one case, not how often it happens.
- What it means for you: If swallowing problems after neck surgery are severe or do not improve with standard care, doctors may want to check for a hyoid fracture using CT imaging. This is a rare possibility, and it does not mean most swallowing problems after surgery have this cause.
The Research Details
This was a case report, which means the researchers carefully described the medical history of one patient rather than comparing a large group of people. The patient was a 76-year-old woman who had a common neck surgery called anterior cervical discectomy and fusion, in which a damaged disc is removed from the front of the neck and the bones above and below are joined together. Her symptoms were tracked over several months, from the day of surgery through a five-month follow-up.
After her swallowing problems worsened, doctors used a CT scan, a detailed set of X-ray images, to look inside her neck. The scan found a small hyoid bone fracture. The team also used a barium swallow test, in which the patient drinks a contrast liquid while X-rays show how food and liquid move through the throat, to measure her progress. Treatment included steroid medicine, IV fluids, a modified liquid diet, and swallow therapy education.
The report also notes that the patient was advised to receive a feeding tube but declined it. Her recovery came from supportive, non-surgical care. Confirmed fusion of the neck bones on imaging was also documented, which helps show that the surgery itself had achieved its structural goal.
A case report is useful for spotting unusual problems that doctors might otherwise miss. In this case, the broken hyoid bone was easy to overlook because swallowing trouble after neck surgery is common and usually temporary. Describing one detailed example helps other doctors know what to look for and which test may find the cause.
Because the case followed the patient over five months, readers can see the full course of symptoms and recovery. This kind of detailed timeline is valuable for clinicians deciding when to scan, how long to wait, and what to expect.
Still, a single case cannot prove that a hyoid fracture caused the problem in general, or how often it occurs. It works best as an early warning signal that prompts further study.
This is a single-patient report, so its findings cannot be generalized to larger populations. The results are based on one person’s medical records and imaging, and the report does not include a control group or statistical testing. The journal is a peer-reviewed publication, which means the report was reviewed by other experts before publication, but case reports are considered lower in the evidence hierarchy than large clinical trials.
The imaging and follow-up details are specific and consistent, which adds some credibility to the account. However, the patient declined a feeding tube, so the outcome reflects non-surgical care in one specific situation, and other patients may have different results.
Readers should view this report as a useful clinical observation that raises awareness, not as proof of a cause-and-effect relationship that applies to all patients.
What the Results Show
The main finding was that a broken hyoid bone, which is a small bone at the base of the tongue, was identified as a likely contributor to severe and lasting swallowing problems in this patient. Her symptoms began after surgery and became worse over time. By the 14th day after her operation, she could barely swallow, had lost about 4.5 kilograms (roughly 10 pounds), and had a constant cough. The CT scan showed a nondisplaced fracture, which means the broken bone had not shifted out of its normal position.
The patient’s treatment focused on conservative care rather than a feeding tube. She received IV fluids to stay hydrated, steroid medicine to reduce swelling, a modified liquid diet, and education on safe swallowing techniques. Her swallowing gradually improved with this approach. The authors described this as the key reason she avoided a feeding tube, although she had been advised to get one.
By 10 weeks after surgery, a barium swallow test showed only mild difficulty. At five months, her symptoms had fully resolved, and imaging confirmed that the neck bones had fused as planned. This timeline suggests that the hyoid injury, while serious, may heal well when managed carefully, although this conclusion comes from one patient only.
The report also highlights that dysphagia, the medical term for difficulty swallowing, is a common effect after this neck surgery and is usually short-lived. Symptoms typically resolve within weeks to months. The patient’s case stands out because her symptoms were severe and lasted far longer than usual, which is what prompted the more detailed imaging.
Another notable outcome was that the patient’s weight loss and persistent cough were important warning signs. These symptoms show why swallowing problems that are getting worse should not be ignored. The report also shows that the neck fusion itself healed successfully, meaning the surgery achieved its main structural goal despite the complication.
The patient’s refusal of a feeding tube and her recovery without one also suggest that some severe cases may be managed without invasive procedures, though the decision to avoid a tube should always be made with a medical team.
Swallowing difficulty after neck spine surgery is well documented in medical literature, and most cases are described as temporary. Hyoid bone fractures are recognized in other settings, such as after neck injuries or certain procedures, but they are rarely reported as a cause of lasting swallowing trouble after this specific type of surgery. This report adds a specific example that fills that gap.
The authors’ recommendation to consider a hyoid fracture when symptoms worsen or stall fits with general medical guidance that persistent or worsening symptoms after surgery should prompt further investigation. The use of CT imaging as the key diagnostic tool is consistent with how doctors typically evaluate bone injuries in the neck.
Because this is one case, it adds to awareness rather than changing established treatment guidelines. Larger studies would be needed to confirm how often this problem occurs and how it should be managed.
The biggest limitation is that the study includes only one patient. A single case cannot show how common a hyoid fracture is after neck surgery, whether it affects men and women differently, or whether the same treatment would work for others. Results from one person can be influenced by her unique health, age, and circumstances.
The report does not state exactly when the fracture occurred or whether it happened during surgery, after surgery, or during a later event. Without that information, it is hard to know whether the surgery directly caused the injury. The study also cannot rule out other possible explanations for the swallowing problems that were not tested.
Finally, the patient declined a feeding tube, so the report does not show what would have happened if she had used one. The recovery timeline reflects only her choices and her body’s response, so it should not be treated as a standard expectation.
The Bottom Line
Research shows that a broken hyoid bone is a rare but possible cause of severe swallowing problems after neck spine surgery, based on one detailed case. Confidence in this specific finding is low to moderate because it comes from a single patient, but the advice to consider this injury when symptoms worsen or stall is reasonable and low-risk. CT imaging is the recommended way to check for it.
Patients who notice worsening swallowing, weight loss, or a persistent cough after neck surgery should tell their medical team promptly. Confidence that prompt evaluation is helpful is high, because persistent symptoms always deserve a check-up.
Decisions about feeding tubes, steroid use, and therapy should be made with a surgeon, a speech-language pathologist, and other clinicians who know the full medical history.
People who have had anterior cervical discectomy and fusion, their families, surgeons, spine specialists, speech-language pathologists, and primary care clinicians may find this report useful. It is especially relevant for anyone whose swallowing problems are severe, getting worse, or not improving with standard care.
People who have not had neck surgery, or whose swallowing problems are mild and improving, are unlikely to need to act on these findings. Most swallowing difficulty after this surgery is temporary and does not involve a fracture.
Anyone with new or serious swallowing trouble, choking, or unexplained weight loss should seek medical care regardless of surgical history.
In the reported case, swallowing improved gradually over several weeks. The patient showed mild difficulty on a swallow test at 10 weeks and had full recovery by 5 months. Most people who have typical swallowing difficulty after neck surgery see improvement within weeks to months.
Recovery times will vary from person to person. Factors such as age, overall health, the severity of the injury, and how quickly symptoms are identified all influence the timeline. Because this was a single case, these timeframes should be seen as one example rather than a guarantee.
Anyone who is not improving over several weeks should talk with their care team about whether further testing is needed.
Frequently Asked Questions
Can neck surgery cause a broken hyoid bone?
A 2026 case report described a hyoid bone fracture in a 76-year-old woman after a C3 to C5 neck fusion. Such fractures appear to be rare, and swallowing problems after this surgery are usually temporary, often resolving within weeks to months.
When should swallowing problems after neck surgery be checked more closely?
Doctors suggest considering a hyoid fracture when swallowing worsens or does not improve with standard treatment. According to the case report, CT imaging is essential to confirm the diagnosis and guide management, especially when weight loss or persistent coughing is present.
How long does it take to recover swallowing after a hyoid fracture?
In the reported patient, swallowing improved gradually with supportive care. She showed mild difficulty on a barium swallow test at 10 weeks and had complete recovery by five months. Results from one patient may not predict timelines for others.
Does every patient with severe swallowing trouble need a feeding tube?
The patient in this case report was advised to get a feeding tube but declined it. Her swallowing improved with IV fluids, steroid medicine, a modified liquid diet, and swallow therapy, showing that some severe cases may respond to non-surgical care under medical supervision.
Want to Apply This Research?
- Log a daily swallowing score from 0 (no trouble) to 10 (cannot swallow at all), along with the types of foods you can eat and any choking or coughing episodes. Track your weight once a week, since unexplained weight loss was a key warning sign in this case.
- Use the app to set reminders for prescribed swallowing exercises and to record how often you complete them. Note any changes in diet texture and share the log with your care team at follow-up visits, so they can see whether your symptoms are improving or stalling.
- Track swallowing scores, weight, and cough frequency weekly for the first three months after neck surgery, then monthly until symptoms have fully resolved. Set an app alert that prompts you to contact your doctor if your swallowing score rises for two weeks in a row or if you lose weight unexpectedly. Keep a shareable summary to bring to appointments.
This article summarizes a single-patient case report and is for general information only. It is not medical advice and cannot replace evaluation by a qualified doctor. If you have swallowing problems, weight loss, or breathing concerns after surgery, contact your surgeon or healthcare provider promptly. Do not change or stop any prescribed treatment, including feeding plans or medications, without consulting your medical team.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.