Hyoid bone

[Calista21269]

Hello,

Does anyone here see anything at the level of the hyoid bone, does this correspond to hyoid bone syndrome in your opinion?

My symptoms: tension in the soft palate, tension and pulling at the base of the tongue, sensation of cables pulling from the base of the tongue to the throat (jugular notch), difficulty swallowing (even saliva), speaking (because of difficulty moving or sticking out the tongue) and tense soft palate, if I speak it pulls towards the area of the soft palate, the base of the tongue up to the cricoid cartilage, as if something is stuck, difficulty breathing deeply because it pulls and sticks towards the area of the thyroid and/or cricoid cartilage, clenched jaw because of all this.

I also sometimes hear cracking towards the cricoid area I think, and sometimes I also have pain on the right side of the hyoid from the thyroid cartilage to the right ear at times.

My tongue is swollen at its base on the right side, and a little numb on the right side of the tongue.

I also hear a noise when I swallow, not really a click, more like a sound of saliva being sucked in and stuck in a narrow place (I hear it around the hyoid area). Since all this, I can no longer burp normally either.

My symptoms get worse if I cough, laugh, cry, sneeze, or blow my nose and if I yawn, it tightens the soft palate area as if it were stretching it, and it also pulls the base of the tongue and throat. I also sometimes have a sensation of a “gag reflex” in my throat, but without nausea, as if something were tightening in my throat up to the diaphragm.

I also feel that it is swollen towards the hyoid area but the doctors do not see anything, I sometimes also feel that it is hot in this area.

I have trouble collecting my mucus, or scraping the roof of my mouth with my tongue, because I can no longer contract the muscles of the soft palate or throat too much, if I do that it makes things worse.

I have already been diagnosed with craniocervical instability (CCI and AAI). My throat problems started after eating a cake and thinking I had choked (because I felt a needle-like prick on the right side towards the thyroid cartilage) so I reflexively contracted my tongue and throat to bring the cake up, then I coughed hard with my head tilted and tried to make myself vomit with a spoon but I didn’t succeed. The next day I had soreness in my tongue and throat and I have had these symptoms ever since.

[Isaiah_40_31]

@Calista21269 - Your styloids are very long & with the symptoms you’ve mentioned, it could be more your styloids causing your throat problems than your hyoid bone. The symptoms involving your soft palate, tongue & throat, difficulty swallowing, & speaking would all be more related to nerves which the styloids irritate than the hyoid bone. Those would be the glossopharyngeal, vagus, & possibly trigeminal nerves.

Hyoid pain can be caused by the styloids when they are long like yours because the calcified stylohyoid ligaments attached to your styloids somewhat tether the hyoid bone & keep it from moving as it needs to when you cough, laugh, sneeze, swallow, breathe, etc.

I think you might get better symptoms relief by having your styloids shortened. Even though the greater horns of your hyoid look a bit long, in some of the images you posted, it looks like there’s a good amount of space between your hyoid & your cervical vertebrae.

Today @TML posted a link to a research paper you will be interested in:

Clicking in the throat (larynx, hyoid bone, thyroid cartilage) - research paper

Hi all, Came across a journal article that I think may be relevant to post here: Many ES members on the forum have clicking in their throat. In this paper the surgeons surgically removed a combination of these areas from the patients and all experiences resolution of their clicking: [Screenshot_2025-09-23-19-27-04-78_40deb401b9ffe8e1df2f1cc5ba480b12] It seems that thyroid, hyoid, and styloid /stylohyoid ligament issues commonly occur together. I posted a research paper previously where mo…

Unfortunately the only doctor we have on our list for your country is possibly not doing ES surgeries anymore, but there is a doctor in Belgium who has done ES surgeries for several of our members in your country.

•Dr. Elisabeth Sauvaget - Hospital St. Joseph, Paris, https://www.hpsj.fr/specialites/oto-rhino-laryngologie-orl/lequipe/ (May no longer be doing ES surgeries)

•Dr. Thierry Ladner, Hospital CHIREC, https://www.doctoranytime.be/d/stomatologue/ladner-thierry?utm_source=gmb&utm_medium=organic&utm_campaign=profile

[Jules]

It is strange because on some of your images both your styloids & hyoid bone processes look longer than others, so it’s hard to tell for sure! Your thyroid cartilage does look quite calcified too, which is common in men but I think less common in women?

[Calista21269]

There are two different scans, one that I did in December, the one with blue and the one with the measurements for the styloid process, and the others are in August.

What will I need to do to get a diagnosis? I don’t know if I have Eagles or hyoid syndrome, but all my symptoms are concentrated around the soft palate, the base of the tongue, and the hyoid and thyrohyoid area.

Some people told me that my hyoid and my Cartilage are close to the cervicals, I saw ENT specialists in France who told me that my styloids are normal for them.. but I don’t believe any French doctors..

[Calista21269]

I don’t know if it’s eagles or HBS, because my symptoms are located towards the soft palate, the base of the tongue, but also towards the hyoid and thyrohyoid area, I don’t have pain towards the tonsils or any pain in the throat, it’s more of a discomfort and when I have pain it’s near the thyroid cartilage, the hyoid and up to the ear, so I’m lost..

Doctors in France are not even worth it, it’s really a disaster..

[Calista21269]

If I do hyoid surgery by cutting the hyoid horns and thyroid cartilage as well as the stylohyoid ligament, even if it is eagles, it can help, right?

I don’t want to cut the styloid process because Dr. Centeno says that just cutting the sh ligament is not good for the CCI, so I imagine the styloid process is worse..

[Jules]

The whole CCI & styloids issue & whether they help stabilise the neck has been discussed quite a bit- some doctors believe that they do & removing them can make instability worse, but other doctors disagree, & there is a possibility that the calcified styloid ligaments could actually be pulling on neck muscles & contributing to CCI- if I remember right, @TML put forward a very logical sounding argument for that one! And there’s no agreement with members who’ve had surgery either; some feel their instability isn’t any worse, and some feel it is, so that’s a tough decision to make!
If you’re not getting anywhere with Dr Dewan soon, @TML has posted a research paper by a doctor in Utah - he did a successful hyoid surgery for one member but we hadn’t heard about others, according to the research paper he’s done 11 surgeries:
Clicking in the throat: cinematic fiction or surgical fact? - PubMed
Dr Marshall Smith, Salt Lake City (Successful thyroid cartilage surgery on ramblinman but does not do ES surgery) Marshall E. Smith | University of Utah Health
Unfortunately unless you had either surgery, it’s impossible to say whether all your symptoms or just some of them would go I’m afraid

[Calista21269]

Thanks for your reply! Do you know where I can find TML’s explanation on the fact that the stylohyoid ligament contributes to pulling on the muscles and worsening the CCI ? Because I’ve already heard that too, I’d like to read it.

[TML]

In summary I argued that elongated styloids cause muscle compensations (and loss of proper range of motion) and reduced use of the deep anterior cervical neck flexors, which are important for stabilizing the cervical spine. Members are often worried to get their styloids removed as doctors sometimes think it can make CCI worse. I think it could at first as the body adjusts to using the weaker but appropriate muscles, but once the proper patterns of use is consistent the instability will get better. Doctors sometimes think elongated styloids are a response to CCI to help stabilize things, but I don’t see physiologically how styloids stabilize the spine. So I think it’s more likely (in my non-doctor opinion) that elongated styloids can cause CCI symptoms due to chronic muscle imbalances

[TML]

Can you show us the axial view of your hyoid greater horns? I can see if they are digging into anything:

[Calista21269]

Yes, I will look at that and post it. Thank you !

[Calista21269]

even if we have the calcified stylohyoid ligament only near the hyoid bone only? can this contribute to worsening the CCI and pull on the muscles and promote forward head posture?

[TML]

@Calista21269 potentially. But more likely elongated styloids (which it appears you have) at the skull base would cause the forward head posture in aims to subconsciously increase the space between the styloids and C1 to allow room for the IJVs and important nerves.

I can check that styloid-C1 space for you too in the axial view. Go to the axial view and find C1 - you’ll see a white circle in the top middle!

[TML]

[Calista21269]

I dont if its the good images ..

[TML]

@Calista21269 are you able to download Radiantviewer and open your CT imaging in there and construct a 3D model? I see your other ones up there but I just want to see it in Radiantviewer since I’m more used to looking at 3D models there

[TML]

@Calista21269 are these two images from the same CT scan?

The 3D model looks like your left styloid is basically in contact with C1, while the axial view shows decent space.

Are you able to upload the axiak view of C1 from both of your CT scans so I can compare?

[Calista21269]

Can I send it to you by email? Because I have a scan done in December, another one recently, and a CBCT done in Barcelona for the diagnosis of ICC, can I send you by email the CT scan from December and the recent one?

[TML]

What could be best is to put the CT files into a google drive folder and then private message me a link to the folder. You would no longer be anonymous to me, but I wouldn’t be sharing any of your personal health info to the forum.

[Calista21269]

I sent you a private message, thank you.