Hey all! Finally got the time to upload my CT scan to Radiant. I’m trying to find what is causing my Eagle-like symptoms and the clicking in my throat. My styloids are not long but kinda chonky. Not sure if I’m seeing it correctly but it looks like one side is compressing a vein. There’s also 2 big chunks of what look to be bone below my hyoid- not sure what that is…also my hyoid bone does look a bit long and there’s 2 hook looking things on both sides near the middle of it before the horns. That’s all I could find that looks a bit different than a normal scan. What do ya’ll think??
Your styloids aren’t long but are somewhat thick & have grown at a less steep angle than we often see on our forum. The thickness & angle of growth could be causing at least part of your symptoms.
Your internal jugular veins look good to me, but the greater horns of your hyoid do look long. The calcification below your hyoid could be on your thyroid cartilage, but I’m not sure about that.
The hooky things are the lesser horns of your hyoid. They are the attachment points for the stylohyoid ligaments. I’ve annotated one slide so you can see if I’ve picked out what you’re looking at.
The good news is we have at least two doctors on our Doctors List who do hyoid surgery - Dr. Cognetti in Philadelphia, PA, & Dr. Dewan in Shreveport, LA.
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@Isaiah_40_31 thanks for the feedback! I wish I had experience reading head and neck X-rays like I do with dental X-rays…I could tell if something was wrong with my teeth but what the heck is a normal hyoid bone supposed to look like?? Haha. Thanks for pointing out the lesser horns! If the greater horns are longer than average could it be colliding with my vertebrae, I wonder?
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Yes, that’s sometimes the problem with elongated greater horns - they make contact w/ the vertebra which isn’t very comfy but could be the source of clicking, etc. that you feel/hear.
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@Isaiah_40_31 Oh wow! It’s almost like I may have known my hyoid was the issue from the beginning glares at both ENT’s 
I’m going to try and measure it with the program later on and I’ll come back to update!
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I just took the measurements and if I did it right…holy cow this thing is definitely longer and thicker than it should be!! and only a few millimeters from my vertebrae 
is there a more accurate way to measure it?
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I searched around on the internet to see if there is an average length for the greater horns of the hyoid & found one article that said something about it being 1.9 cm in men though I may have misinterpreted that. Regardless, yours at 2.94 cm is definitely longer than that. The way you measured it looks fine though I don’t know if a doctor would agree, but regardless, it does seem you may have Hyoid Bone Syndrome as opposed to ES. You can search for forum posts about HBS using the magnifying glass image in the upper right of this page. Good job sleuthing this out!
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Thank you so much for doing that! No wonder I’ve been so miserable…that’s crazy. I may have found my smoking gun. And yes you are right, I would need to get it measured by a radiologist for any doc to take that seriously, most likely. I’m about to have a brain MRI to rule out all the neurological issues, that would be a great time to do it! Dr Dewan is closest to me so I think I will chose her for my surgery if that is the case 
@Isaiah_40_31
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Indeed your hyoid bones are long, and may be your problem. Mine are 3.3cm but are 6mm from my cervical spine so my issue does not seem to me at the back of the throat, but rather at the front. Catching of the hyoid may well be causing your symptoms, especially what you said in your other post about left and right sides symptoms.
The region underneath that you have arrowed and circled in red appears to be ossification or calcification of the thyroid cartilage. That happens over time. Mine is almost completely calcified, unusually so for a female my age, and i think that’s what’s doing it for me.
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This is mine, much larger extent of ossification. Just for your info. Doctors haven’t said anything is unusual about it though. Happens with age. I’m 40.
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It’s certainly worth looking into HBS I would think looking how long your greater cornu are!
Let us know if you get to see Dr Dewan… there are another couple of doctors on the list who have done hyoid surgery but not any nearer you I guess:
Dr Brad deSilva, OSU Wexner Hospital, Ohio https://wexnermedical.osu.edu/find-a-doctor/brad-desilva-md-22675 He has also done hyoid bone surgery.
Dr Marshall Smith, Salt Lake City, Utah (Successful thyroid cartilage surgery on ramblinman)
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@F_t - The calcification on your thyroid cartilage is pretty scary looking. Do you think it’s causing some of your symptoms?
Absolutely definitely 100% yes! 
But convincing the doctors of that is an entirely different thing.
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@F_t it definitely looks like your thyroid cartilage is causing the issues! I’m so sorry, that looks very unpleasant 
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Thought I would post a small update- not much movement has happened yet but I called Dr. Dewan’s office today and she takes my new insurance!! I did find out that she is referral based only and my PCP doctor is on vacation until next week, so I will have to wait for her to get back but I am sure she would write me a referral to have a consult with her.
I’m also in the process of submitting my records to Dr. Chhetri at UCLA, but since I am not a CA resident, I have to have my doctor sign off on a second opinion and she has to be available to join our telehealth consult. So again, I am waiting on her to return from vacation.
Just thought I would put this out there in case someone else is interested in seeing either of these doctors. It is a slight process. Fingers crossed for me that I can get a consult soon!
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It’s great news that Dr. Dewan takes your insurance. That will certainly be helpful come surgery time. I’m glad your PCP will be back soon, but sorry she’s not here this week. It’s tough to be patient when trying to get the ball rolling toward feeling better!
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I hope you can get those appointments sorted soon
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Update!
I finally got my referral sent over to Dr Dewan and her team and the scheduler called me back yesterday and scheduled me for her soonest consult which is Aug 12th at her dysphagia clinic!! I was so excited I literally ran around my house telling all my family members and called my bf while he was working LOL. I really think she is going to be the one that saves me. I cannot wait to meet her in a couple months!
I also saw my neurologist today on the referral for glossopharyngeal neuralgia. I also told her about my hyoid bone syndrome symptoms and she explained to me why she doesn’t think I have neuralgia and she agrees with me that what I’m dealing with is a functional/mechanical/anatomical problem!! I swear I’ve been trying to tell all these docs that from the beginning. She said she couldn’t comment on the hyoid bone because it’s not her area of expertise and thinks we would have seen an abnormality on the CT scan (which I did when I turned them into 3D) so I took that with a grain of salt. She ordered me an MRI of my brain and neck and also that video swallow study so I will literally have every test under the d*mn sun after that. I will be promptly sending them over to Dr Dewan and her team once they come back
Just have to make it through the coming weeks (54 days, yes I am counting) until I can meet my future surgeon. At this point there is pretty much no doubt in my mind that I was right all along! Thanks for the continued support on here, I will update again when I know more!
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That’s FANTASTIC NEWS!! @a_catindisguise!! Good for you knowing your body & following your suspicions to a helpful conclusion. It’s also super that your neurologist is now on the same page & is supportive of the information you’ve given her re: HBS!
Please let us know how your appt. goes on 8/12, and of course, we’re here for you in the meantime.
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That’s really good news, glad that you’re another step forward, & hope that those 54 days pass quickly for you!
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