Painful conditions of unexplained origin pose a challenging task for the clinician from both the diagnosis and treatment perspective. This might be accounted due to overlapping symptomatology; moreover, nonspecific subjective findings push the diagnostic process to a more perplexing direction.
The main loophole in their management lies in difficulty to make an appropriate diagnosis. Clicking hyoid is an extremely rare anomaly of hyoid bone which produces painful clicking in throat.
Here, we report a case of a young patient presented with pain and clicking in throat which aggravated on swallowing. After a series of examinations, it was diagnosed as clicking hyoid and was managed successfully by surgical treatment. The objective of this article is not only to increase awareness of the ailment so as to validate its existence but also demonstrate the significant utility of the surgical management.
Painful clicking in the throat is a rare entity to be encountered in the clinical settings. Its diagnosis is equivalent to solve a puzzle and is primarily based upon exclusion criteria.
Clicking hyoid is an abnormal condition of hyoid bone which is characterized by enlargement of greater cornua of hyoid bone. These enlarged cornua impinge on cervical vertebrae. This impingement of cervical vertebrae produces interosseus friction. This frictional relation between the two bones is responsible for pain and clicking sound which is perceptible to the patient. The pain and clicking usually aggravates on swallowing as well as on neck movements.
The abnormal enlargement can be a sequel of trauma. Clicking sensation and pain while deglutition is an unpleasant condition, which produces physiological and psychological bearings. This dictates the need for accurate diagnosis and proper management of the condition.
Different modalities of treatment have been reported in the literature. These include conservative and surgical approaches. Here, we report a case of a young female who visited to seek treatment for suspicion of some cancerous lesion causing pain and clicking in throat. Due to long standing history of problem, the patient started developing loss of interest in surroundings and sleep disturbances lending her to life of senility and seclusion.
The patient was diagnosed as a case of clicking hyoid. The case was managed surgically with resection of greater cornua of hyoid. This was associated with pain but no difficulty on swallowing.
She denied of any previous history of trauma. She did not have any respiratory symptoms or jaw-locking. Taking into consideration, the patient's symptom logy; it was suspected to be a case of the salivary gland sialolith. On sialography and ultrasonography, no such finding was evident. On clinical examination, a trigger point was palpable on anteroinferior aspect of masseter muscle. Patient had an associated sleep disturbance and loss of interest in surroundings.
Beck's depression index was used to assess the depression associated with pain. Patient was found to have moderate depression. She was given trigger point injection with 0. However, patient had no relief. For alleviation of pain associated depression, tricyclic amitriptyline antidepressant 75 mg was used for 3 weeks.
Patient got no relief in pain and clicking. On further examination of throat, CT scan was done [ Figure 3 ] greater horn of hyoid bone was found large in size with abnormally long greater cornua. While swallowing, a significant click was as greater cornua were impinged, caught, and slipped back the spine.For many people, chewing and swallowing is a simple process that does not produce any cause for concern.
But when something is amiss and not performing as it should, we become worried. Our oral cavity is made up of several structures involved in digesting food.
Our jaw muscles, tongue, and esophagus all work in concert with each to get our food down to your stomach. This process not only requires the contraction of muscles, but also the management of bite force, air that we inhale while chewing, and the balance of various pressure systems found within the head. However, experiencing a clicking sound when swallowing may be due to an underlying condition that should be brought to the attention of a medical professional.
While the most obvious symptom is the production of a clicking sound, the following symptoms may also be present:. Also known as the auditory tube, this structure connects to part of the middle ear, which is filled with air and closed off from the atmosphere outside the body, and back to the nasopharynx the connection between the nasal cavity above the soft palate of the mouth.
Normally, the eustachian tube is collapsed but opens up both when swallowing and with positive pressure as is the case from taking off or landing on a plane. This change causes the air in the middle ear to expand and contract, which causes this structure to push into the back of the nose and mouth. A balance of varying pressures within the head needs to be maintained.
However, they may consequently be producing a clicking sensation when you swallow. A rare abnormal condition of the hyoid bone, which is a horseshoe-shaped boned found on the anterior portion of the neck. A clicking hyoid can be painful, as it is characterized by enlargement of the greater cornua of the hyoid bone, which can impinge on the cervical vertebrae. That may cause an abnormal clicking sound when swallowing.
Temporomandibular joint syndrome disorder TMJ disorder :. This disorder is characterized by excruciating pain or tenderness of the jaw. We use our jaw muscles every day to chew our foods, to speak, and even simply just breathing through our mouths. All of these actions rest upon a joint called the temporomandibular joint. This sliding hinge can be the source of pain felt in the joint itself as well as the muscles that control jaw movement. The exact reasons for TMJ disorder development may be difficult to determine, but it can be the result of several factors including genetics, arthritis, or jaw injury.
A person is still able to swallow fine, but it can become quite irritating. A condition caused by the incomplete closing of the lower esophageal sphincter causing stomach acid to escape up into the esophagus causing pain.
If occurring for long enough, it may become a condition called gastroesophageal reflux disease GERDwhich can cause referred pain to the back, in the region between the shoulder blades. Untreated GERD has been associated with the development of cancer in the long term. Some patients may experience clicking when swallowing with GERD.
Considering the fact that there are many possible causes for why you may be experiencing clicking when swallowing, each particular cause involves its own particular diagnostic testing with its own therapeutic treatment. For example, having GERD will require the utilization of antacid medication to help reduce the production of stomach acid or being diagnosed with Globus pharyngitis surgery may be required to help provide relief.
However, it is important to keep in mind that having a clicking sound when swallowing may be just a normal phenomenon that occurs when the body is working as it should.Ask doctors free.Digastric muscle - Origin, Insertion, Innervation \u0026 Function - Anatomy - Kenhub
A year-old female asked:. Philip Miller answered. Hyoid click: Doubtful- the clicking is common with a lax hyoid and as long as your thyroid is normal in size and shape, do not panic. Good idea to make an appointment for an ultrasound of the thyrod and a medical exam.
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Related questions: A year-old male asked:. Mark Loury answered. You are right: It is either the hyoid or laryngeal cartilage moving along the spine and catching. I have pain in left side of neck after yawning, swallowing or looking down. The pain is around thyroid or hyoid bone area.
Hyoid bone clicking while swallowing - Ehlers-Danlos Syndromes
Possible cause? Requires exam: you will need an examination and an ultrasound of your neck and thyroid. Or leave it alone? Its discomfort. Stephen Rothstein answered. Hyoid: Drink more water, warm soaks twice a day for a few days and ibuprofen. Sometimes we scan it if there was a trauma history. My thyrohyoid membrane between hyoid bone and thyroid cartilage hurts a lot when it is touched, like a sore pain. Could this be serious? Michael Kleerekoper answered.Hello, I have swallowing issues, my hyoid bone clicks while swallowing, also pops out while turning my head to the left, it feels like my throat is unstable.
Also I have a huge pain in front of my neck and around my throat, similar to strangulation feeling. These symptoms started after I experienced a cervical spine trauma at the c3-c4 level, at the same level, where hyoid bone is. These symtoms are unbearable, I can't live with that. I wonder if there are people who have similar symptoms and if someone found the solution?
I have been to various medical doctors, but they don't know, how to solve it No pain. Diagnosed and have a few questions. Hi yes I've had similar swallowing difficulties and feeling like I'm being strangled.
It is unbearable! I have EDS and cervical dystonia, complicated issues. Two things have helped some. Make sure it is a swallow therapist who does physical therapy for all the muscles used in the throat tongue lips etc. I know it is so difficult but give it a try! I'm not back to normal ever but I keep doing the exercises and it's more manageable now. Good luck! FYI, most of us do not even notice when we first post a discussion that Inspire has it set up where All discussion threads go to an automatic default position of [Shared with the Public] The op of the thread can if desired, change the setting by clicking on Edit, going back in to select another setting.
I hope that my probably a little bit lengthy?
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What is causing a clicking sound when I swallow?
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