Consideration of Hyoid Variability in the Diagnostic Workup of Fishbone Foreign Body Aspiration

Abstract

Fishbone foreign body (FFB) can lodge in the upper respiratory or gastrointestinal tracts and frequently cause discomfort. While FFBs are common, variations in the hyoid may present radiographically similarly. The authors present a case in which a 32-year-old woman presented with pain in the right neck with a globus sensation after eating fish. Examination, including flexible fiberoptic laryngoscopy, did not reveal a foreign body. Given the patients’ persistent symptoms, a noncontrast computed tomography was performed, demonstrating a radiopaque body superior to the right lateral hyoid bone, consistent with FFB. Direct examination under anesthesia was performed, and no FFB was noted. A reassessment of the imaging suggested a likely aberrant hyoid bone. The authors report this case to remind clinicians that while rare, aberrant hyoid variants may mimic FFB. The authors also review the imaging findings of aberrant hyoid variants in this report, as recognition of hyoid variability can mitigate unnecessary intervention.