Hyoid bone elongation

In my non medical opinion I would say that your styloids are longer than the ‘average’, the left especially, and it’s quite angled, so could possibly be causing symptoms as well as the hyoid bone.

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Good for you! It is fascinating to see. I’m not knowledgeable enough to speak about the left side asymmetry circled in red …looks like at your thyroid area.
And agree styloids appear thick and getting close to top and bottom edge of the transverse processes of C1…and could be causing symptoms.
The hyoid bone as you can see, sits high near the top of the throat. Can you feel the clicking externally with your hands and can you tell if it at the top of your throat or lower near the thyroid?

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I’d also add that the neck curvature seems to be lost (“military neck”) and there are some signs of thinning intervertebral discs, which might be just a simple ageing process, or it could be something symptomatic.

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I agree w/ both @Jules re: your styloids are longer than average, left side is quite angled, & both are thick especially at the top.

@vdm’s note regarding complete loss of lordotic neck curve is also significant as this puts extra strain on the neck & supporting muscles/soft tissues & can make ES symptoms worse.

I’ve done some annotation on a couple of your images as I see the right greater horn of your hyoid has a slight upturn which could be why you’re more symptomatic on the right as the right side may have greater contact or initial contact w/ your cervical vertebra when the hyoid moves…


Note the difference in the angle of each greater horn. The left goes more straight back where the right side curves upward.

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I feel the clicking on the left side where the red circle is. Doesn’t seem to be at the back of the hyoid bone to me. Unless it is a case of the hyoid bone being unable to move properly which is then causing the click at the front? I’m not sure.

Thank you for all your opinions, great to have people with some insight to this strange condition. I agree with the straight neck, but I was lying down with a support pillow under me. I’m going to give physio a try to sort out my neck muscles, and failing that, will go get a second ENT opinion. In March. Because that’s how long the wait is here! Fun. My anxiety meds are due to kick in soon, NEVER underestimate the mental impact of challenging physical conditions. Mental support is just as important as physical, especially when being told there is nothing that can be done. I shall keep you all updated in case others on the forum have similar issues.

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You’re so right about the mental impact of challenging physical conditions. They do take a toll. Constant pain (& in your case clicking in the throat) can drive us into depression even when we’re normally happy people. I’m glad the anti-anxiety meds are helping you cope for the time being. Hopefully you won’t need them for long.

I hope you’ve got that March appt. scheduled so you don’t need to wait any longer if the PT doesn’t help, but I hope PT makes a night & day difference for you @F_t. You know where to find us if you need virtual hugs & encouragement along the way. :blush: :hugs:

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I just tried out the Radiant viewer. Got a couple of measurements of my laryngeal cartilage to take to my next ENT appointment. Take a look at the 3mm difference on the side that aches and clicks! That’s one pointy bit of bone i suspect should not be there…

Oh and the specialist PT told me yesterday that she’d give me one more session to try to help me with my musculature, then if that made no difference, she said she couldn’t help me and it would be a case for surgery.

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Hi all again, I’m due back at the doctors next week, and trying to arm myself with as much info as possible. I’m wondering if anyone would be willing to do me a favour and measure the distance between the base of their hyoid bone and top of thyroid cartilage on their 3d images (visibility on 3d scan will depend of calcification extent of course)?? I’m interested to see whether my 7mm is an unusually short distance, and there are very few journal articles on this! I would really appreciate your help. Thank you so much.

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I haven’t got scans so can’t help with the measurements I’m afraid, but hope that your doctor listens to you tomorrow and that you get some answers. Sending you a hug & let us know how you get on :hugs: :pray:

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Thank you Jules. :blush:

I have scans, but they don’t cover my thyroid area. I’m sorry I can’t help either!

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Wellllll… that went just as expected… Had my second opinion ENT appointment this morning and i was told that everything i had been told previously was wrong. Was told to stop all medication and dietary modifications because my clicking hasn’t got anything to do with anxiety or reflux. Unfortunately i was also told that the clicking in my throat when swallowing was a normal sensation. I’m 40 years old, i think i know what swallowing feels like, this is not normal. The doctor says that surgery won’t help because he doesn’t know what is causing it. But there is a positive in that he’s giving me an injection in the surrounding ligament (I’m not sure what or where, i was too overwhelmed to take it in), in the hope that it will heal any inflammation in the region. I have also contacted the authors of the papers on clicking larynx syndrome, one of whom has said to me that what i have found might be the cause of my issues. So it may be that I’ll have to travel to Germany to see an expert, or at least put my ENT in contact with him! I am just posting this to vent to an understanding ear, really, thank you for listening to my TED talk! :laughing:

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Where can i find this software ? Is it like you upload your normal black and white ct scan and the software can transform and convert itself to 3D in this software ?

I have only been able to see my ct scan in 3D at my ENT doctor and surgeon. Would be nice to study a 3D version for myself.

-Henrik

Ooh it’s amazing and actually so much fun! Slicer3D and RadiAnt are the two softwares that i used, and i think both have very well written instructions by the lovely people in this forum. Have s search for them in the search box, mostly because i don’t know how to link to the other discussions!

You’ll need to have your ct images sent to you, or ability to access and download them online. Then you pop them into the viewers and look around.

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Thanks. I have acces to my CT scan, i will chek it out again thanks !

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Well at least it was recognised that the clicking wasn’t anxiety or reflux , but so frustrating that you were fobbed off again!
Maybe you could do an online consultation with Kjetil Larsen (he has written numerous research articles about biomechanics, IJV stenosis, TOS etc and has helped several members with interpreting their scans.) Appts are only available online currently:
Home - MSK Neurology
He seems very knowledgeable, might be worth doing before you travel to Germany, or are they able to view your scans and do online appts?
Sending you a hug :hugs:

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I agree with Jules that left styloid process looks a bit pointy/angled and the thickness is somewhat off in my point off view. I must disclaim that i have no medical expirence, im a patient myself.

Looks like the styloid goes into and behind the jawline.

-Henrik

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I totally agree with @vdm about hyiod bone is slightly too high, it is difficult to study your 3D scan because off thickness in slices, by the looks of it looks like hyoid bone is “stabbing” your neck.

There is studies off hyoid bone misaligment, that causes clicking sound, hard to swallow, foreign object sensation in throat,caughing and sleep napnea.

https://study.com/academy/lesson/dislocated-hyoid-bone-symptoms-treatment.html

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