@Rfoxed - I’m very sorry that your consult w/ Dr. Cognetti more or less ended with a dead end as far as a diagnosis. Another doctor to consider is Dr. Dewan in Louisiana, but she doesn’t do virtual consults. You’d need to travel to see her. Your story sounds very much like our member @a_catindisguise who was diagnosed w/ clicking larynx syndrome by Dr. Dewan who ultimately did her surgery. Here are links to a couple of her discussions:
It is my firm belief that symptoms can reveal more than imaging does i.e. we’ve had a few members w/ terrible ES type nerve pain but not elongated styloids yet the symptoms ended up being caused by the styloids due to some irregularity in their physical form or features i.e. thickness, how curved, angled, pointed, twisted, lump, etc. they were. Doctors normally won’t consider the physical features of the styloids beyond their length when diagnosing ES. Thus, I believe the greater horns of the hyoid bone might not necessarily need to be super long to be causing problems. They can also exhibit physical characteristics of being very thick, curved, twisted, pointed, etc. Thyroid cartilage itself can also be excessive or calcified which can contribute to clicking larynx syndrome. Dr. Cognetti may not have considered these things when looking at your scans even though he’s very experienced.
Going to see Dr. Dewan may be your best chance at getting a diagnosis since her specialty is hyoid bone/clicking larynx syndromes.
•Dr. Karuna Dewan, Ochsner LSU Health Shreveport - Academic Medical Center - Specializes in Hyoid Bone Syndrome surgeries
1541 Kings Hwy, Shreveport, Louisiana, 1-318-626-0050
Karuna Dewan, MD | Ochsner LSU Health