Thyrohyoid and its significance

  • Sudha Ramalingam Sri Manakula Vinayagar medical College and Hospital, Pondicherry
  • Deepa Somanath Sri Manakula Vinayagar medical College and Hospital, Pondicherry



The thyrohyoid muscle is one of the infrahyoid muscles located on the deeper layer of the infrahyoid muscles attached to the oblique line of the thyroid cartilage. The activity of the THM is required in deglutition, phonation and respiration. This article explains the various aspects of the muscle regarding its anatomy, development and clinical correlation.


1. Cheon JH, Nam DH, Kim H, Lee DY, Cho YK, Kang EY, et al. Ultrasonographic measurement of thickness of the thyrohyoid muscle: A pilot study. Ann Rehabil Med 2016; 40(5):878–884.
2. Kirzinger A, Jürgens U. Role of extralaryngeal muscles in phonation of subhuman primates. J Comp Physiol A 1994; 175(2):215–222.
3. Mnatsakanian A, Al Khalili Y. Anatomy, Head and Neck, Thyroid Muscles. StatPearls [Internet] 2019; 1–4.
4. Ericsson R, Knight R, Johanson Z. Evolution and development of the vertebrate neck. J Anat 2013; 222(1):67–78.
5. Theis S, Patel K, Valasek P, Otto A, Pu Q, Harel I, et al. The occipital lateral plate mesoderm is a novel source for vertebrate neck musculature. Development 2010; 137(17):2961–2971.
6. Sato I, Ueno R, Sato T. A consideration of the normal and abnormal human suprahyoid and infrahyoid musculature . Okajimas Folia Anat. Jpn 1987; 64(1):17-38.
7. Kitamura S, Nishiguchi T, Sakai A. Location of cell somata and the peripheral course of axons of the geniohyoid and thyrohyoid motoneurons: A horseradish peroxidase study in the rat. Exp Neurol 1983; 79(1):87–96.
8. Senthil Murugan M, Sudha R, Bhargavan R. Clinical significance of an unusual variation: Anomalous additional belly of the sternothyroid muscle. Sultan Qaboos Univ Med J 2016;16(4):491–494.
9. Müller F, O’rahilly R, Tucker JA. The human larynx at the end of the embryonic period proper: I. The laryngeal and infrahyoid muscles and their innervation. Acta Otolaryngol 1981; 91(1–6):323–336.
10. Bliss RD, Gauger PG, Delbridge LW. Surgeon’s approach to the thyroid gland: Surgical anatomy and the importance of technique. World J Surg 2000;24(8):891–897.
11. Paraskevas GK, Raikos A, Ioannidis O, Saberi BB. Topographic anatomy of the internal laryngeal nerve : Surgical considerations. Head & Neck 2012;24: 534-540.
12. Tamaki A, Thuener J, Weidenbecher M. Superior Laryngeal Nerve Neuralgia: Case Series and Review of Anterior Neck Pain Syndromes, Ear, Nose Throat J 2019; 1-4.
13. Sonoda N, Tamatsu Y. Observation on the attachment of muscles onto the hyoid bone in human adults. Okajimas Folia Anat. Jpn 2008; 85(3):79–90.
14. Tanaka S, Asato R, Hiratsuka Y. Nerve-muscle transplantation to the paraglottic space after resection of recurrent laryngeal nerve. Laryngoscope 2004; 114:1118-1122.
15. Hisa Y, Malmgren LT, Gacek RR. Actomyosin adenosine triphosphatase activities of the cat infrahyoid muscles. Ann Otol Rhinol Laryngol 1989;98(3):202–208.
16. Hisa Y, Malmgren LT, Lyon MJ. Quantitative histochemical studies on the cat infrahyoid muscles. Otolaryngol - Head Neck Surg 1990;103(5)723–732.
17. Korfage JAM, Schueler YT, Brugman P, Van Eijden TMGJ. Differences in myosin heavy-chain composition between human jaw-closing muscles and supra- and infrahyoid muscles. Arch Oral Biol 2001; 46(9):821–827.
18. Miyazaki T, Yoshida Y, Hirano M, Shin T, Kanaseki T. Central location of the motoneurons supplying the thyrohyoid and the geniohyoid muscles as demonstrated by horseradish peroxidase method. Brain Res 1981; 219:423–427.
19. Yoshida Y, Miyazaki T, Shin T, Hirano M, Kanaseki T. Topographic arrangement of motoneurons innervating the suprahyoid and infrahyoid muscles: A horseradish peroxidase study in cats. Ann Otol Rhinol Laryngol 1983; 92:259–266.
20. Ueyama T, Satoda T, Tashiro T, Mizuno N. The distribution of infrahyoid motoneurons in the cat: a retrograde horseradish peroxidase study. Anat Embryol 1988; 177:445–450.
21. Kitamura S, Nishiguchi T, Okubo J, Chen K, Sakai A. An HRP study of the motoneurons supplying the rat hypobranchial muscles: central localization, peripheral axon course and soma size. The anatomical record 1986; 216:73-81.
22. Romanes GJ. Cunningham’s text book of anatomy. 11th edition. Oxford university press, London 1972; 707-793.
23. Chhetri DK, Berke GS. Ansa cervicalis nerve: Review of the topographic anatomy and morphology. Laryngoscop 1997;107:1366–1372.
24. Banneheka S. Anatomy of the ansa cervicalis: nerve fiber analysis. Anatomical Science International 2008; 83:61-67.
25. Sakamoto Y. Morphological features of the branching pattern of the hypoglossal nerve. The anatomical record, ‘Accepted article’doi: 10.1002/ar.23819.
26. Fukushima S ichi, Shingai T, Kitagawa J, Takahashi Y, Taguchi Y, Noda T, et al. Role of the pharyngeal branch of the vagus nerve in laryngeal elevation and UES pressure during swallowing in rabbits. Dysphagia 2003; 18(1):58–63.
27. Wang RC, Puig CM, Brown DJ. Strap muscle neurovascular supply. Laryngoscope 1998; 108:973–976.
28. Eliachar I, Marcovich A, Shai H, Lindenbaum E. Arterial blood supply to the infrahyoid muscles: An anatomical study. Head and Neck surgery 1984;7:8-14.
29. Pearson WG, Langmore SE, Yu LB, Zumwalt AC. Structural analysis of muscles elevating the hyolaryngeal complex. Dysphagia 2012; 27:445–451.
30. McFarland DH, Lund JP. An investigation of the coupling between respiration, mastication, and swallowing in the awake rabbit. J Neurophysiol 1993; 69(1):95–108.
31. Terrado J, Ortega J. Unilateral agenesis of the thyrohyoid muscle in a dog. The Vet J 2002; 164:156–158.
32. Maranillo E, Sanudo J. Laryngeal muscles. Tubbs RS, Shoja MM, Loukas M. Bergman’s Comprehensive Encyclopedia of Human Anatomic Variation. 2016; (1):254–261.
33. Hong KH, Ye M, Kim YM, Kevorkian KF, Berke GS. The role of strap muscles in phonation - In vivo canine laryngeal model. J of Voice 1997; 11(1):23–32.
34. Ducharme NG, Hackett RP, Woodie JB, Dykes N, Erb HN, Mitchell LM, et al. Investigations into the role of the thyrohyoid muscles in the pathogenesis of dorsal displacement of the soft palate in horses. Equine Vet J 2010; 35(3):258–263.
35. Jüch PJW, Oomen CAM, Van Willigen JD. The effect of infrahyoid-muscle tenotomy on orofacial motor activity in the rat. Arch Oral Biol 1988; 33(7):511–7.
36. Miralles R, Gutierrez C, Zucchini G, Cavada G, Carvajal R, Valenzuela S, Palazzi C. Body position and jaw posture effects on supra- and infrahyoid electromyographic activity in humans. The Journal of Craniomandibular practice 2006;24(2):98-103.
37. Narita N, Yamamura K, Yao D, Martin RE, Sessle BJ. Effects of functional disruption of lateral pericentral cerebral cortex on primate swallowing. Brain Res 1999; 824:140–145.
38. Thexton AJ, Crompton AW, German RZ. EMG activity in hyoid muscles during pig suckling. J Appl Physiol 2012 ;112:1512–1519.
39. Burnett TA, Mann EA, Cornell SA, Ludlow CL. Laryngeal elevation achieved by neuromuscular stimulation at rest. J Appl Physiol 2003; 94:128–134.
40. Harding BYR, Titchent DA. Oesophageal and diaphragmatic activity during sucking in lambs 1981; 321:317–329.
41. Lee HY, Yang HJ. Anterior neck muscles. Tubbs RS, Shoja MM, Loukas M. Bergman’s Comprehensive Encyclopedia of Human Anatomic Variation 2016;228–234.
42. Hilloowala RA. Comparative anatomical study of the hyoid apparatus in selected primates. Am J Anat 1975;142:367–384.
43. Kunjur J, Brennan PA, Ilankovan V. The use of triamcinolone in thyrohyoid syndrome. Br J Oral Maxillofac Surg 2002; 40:450–451.
44. Kim SH, Oh BM, Han TR, Jeong HJ, Sim YJ. Different movement of hyolaryngeal structures by various application of electrical stimulation in normal individuals. Ann Rehabil Med 2015; 39(4):535–544.
45. Altman KW, Atkinson C, Lazarus C. Current and emerging concepts in muscle tension dysphonia: A 30-month review. J Voice 2005;19(2):261–267.
46. Angsuwarangsee T, Morrison M. Extrinsic laryngeal muscular tension in patients with voice disorders. J Voice 2002; 16(3):333–343.
47. Khoddami SM, Ansari NN, Jalaie S. Review on laryngeal palpation methods in muscle tension dysphonia: Validity and reliability issues. J Voice 2015; 1-10.
48. Hertegård S, Granqvist S, Lindestad PÅ. Botulinum toxin injections for essential voice tremor. Ann Otol Rhinol Laryngol 2000; 109:204–209.
49. Antunes EB, Lunet N. Effects of the head lift exercise on the swallow function: A systematic review. Gerodontology 2012; 1-11.
50. Mepani R, Antonik S, Massey B, Kern M, Logemann J, Pauloski B, et al. Augmentation of deglutitive thyrohyoid muscle shortening by the shaker exercise. Dysphagia 2009; 24:26–31.
51. Baijens LWJ, Speyer R, Roodenburg N, Manni JJ. The effects of neuromuscular electrical stimulation for dysphagia in opercular syndrome: A case study. Eur Arch Oto-Rhino-Laryngology 2008; 265:825–830.
52. Baijens LWJ, Koetsenruijter K, Pilz W. Diagnosis and treatment of phagophobia: A review. Dysphagia 2013; 28:260–270.
53. Steele CM, Thrasher AT, Popovic MR. Electric stimulation approaches to the restoration and rehabilitation of swallowing: a review. Neurol Res 2007; 29:9–15.
54. Zantingh AJ, Ducharme NG, Mitchell LM, Cheetham J. Effects of hypoglossal nerve block and electrical stimulation of the thyrohyoideus muscles on position of the larynx and hyoid apparatus in healthy horses. Am J Vet Res 2013; 74:784–789.
55. Van de Graaff WB, Gottfried SB, Mitra J, van Lunteren E, Cherniack NS, Strohl KP. Respiratory function of hyoid muscles and hyoid arch. J Appl Physiol 1984;57(1):197–204.
56. Galline J, Marsot-Dupuch K, Bigel P, Lasjaunias P. Bilateral dystrophic ossification of the thyroid cartilage appearing as symmetrical laryngeal masses. Am J Neuroradiol 2005; 26:1339–1341.
57. Giudice M, Piazza C, Bolzoni A, Peretti G. Head and neck intramuscular haemangioma: Report of two cases with unusual localization. Eur Arch Oto-Rhino-Laryngology 2003;260:498–501.
58. Parajuli R, Thapa S, Maharjan S. Intramuscular hemangioma of thyrohyoid muscle. Case Rep Otolaryngol 2016;1–4.
59. Nagaoka K, Tanne K. Activities of the muscles involved in swallowing in patients with cleft lip and palate. Dysphagia 2007; 22:140–144.
60. Roberts TJ, Caston-Balderrama A, Nijland MJ, Ross MG. Central neuropeptide Y stimulates ingestive behavior and increases urine output in the ovine fetus. Am J Physiol Metab 2000; 279:E494–500.
61. Ross MG, Agnew C, Fujino Y, Ervin MG, Day L. Concentration thresholds for fetal swallowing and vasopressin secretion. Am J Physiol Integr Comp Physiol 1991;R1057–1063.
62. Dolivet G, Gangloff P, Sarini J, Ton Van J, Garron X, Guillemin F, et al. Modification of the infra hyoid musculo-cutaneous flap. Eur J Surg Oncol 2005; 31:294–298.
63. Deganello A, Leemans CR. The infrahyoid flap: A comprehensive review of an often overlooked reconstructive method. Oral Oncol 2014; 50(8):704–10.
64. Tincani AJ, Del Negro A, Costa Araújo PP, Akashi HK, da Silva Pinto Neves F, Martins AS. Head and neck reconstruction using infrahyoid myocutaneous flaps. Sao Paulo Med J 2006;124(5):271–274.
65. Peng H, Wang SJ, Yang X, Guo H, Liu M. Infrahyoid myocutaneous flap for medium-sized head and neck defects: Surgical outcome and technique modification. Otolaryngol - Head Neck Surg 2013;148(1):47–53.
66. Mirghani H, Meyer G, Hans S, Dolivet G, Périé S, Brasnu D, et al. The musculocutaneous infrahyoid flap: Surgical key points. Eur Arch Oto-Rhino-Laryngology 2012; 269:1213–1217.
67. Gangloff P, Deganello A, Lacave ML, Verhaeghe JL, Lapeyre M, Maire F, et al. Use of the infra hyoid musculo-cutaneous flap in soft palate reconstruction. Eur J Surg Oncol 2006;32:1165–1169.
68. Guzeldir OT, Aydil U, KizilY, Akyildiz I, Koybasioglu A. The effect of infrahyoid muscle sectioning on hyoid bone position and oropharyngeal air column volume. NA Laryngoscope 2015;165:1480-1484.
69 . Todd NW. Common congenital anomalies of the neck: Embryology and surgical anatomy. Surg Clin North Am 1993;73(4):599–610.
How to Cite
RAMALINGAM, Sudha; SOMANATH, Deepa. AN OVERVIEW OF THE THYROHYOID MUSCLE, ITS CLINICAL AND SURGICAL IMPLIlCATIONS. Journal of Morphological Sciences, [S.l.], v. 2, n. 2, p. 79-88, dec. 2019. ISSN 2545-4706. Available at: <>. Date accessed: 25 sep. 2022.