Hyoid bone fracture: an unrecognised complication of intubation or transoesophageal echocardiogram?

A 55-year-old man sustained a compound hyoid fracture in the perioperative period surrounding coronary artery bypass surgery. The two most likely mechanisms of injury were external laryngeal pressure sustained either during transoesophageal echocardiogram (TOE) or intubation. He was managed operatively and made an uneventful recovery. The procedure that led to the hyoid fracture was not determined. Of note, this has not been previously described as a complication of either procedure.