For those that have seen Jonathon Hughes. Did he have to see something definitive on your scans for him to consider treatment/surgery? I ask as despite me being able to obviously demonstrate in person that catching/clicking on the cartilage in my throat and the back right of my hyoid rubbing against bone or some other hard structure, for some baffling reason nobody has been able to see this on my scans. The only thing that can obviously be seen is bolus/food shooting to the left side of throat when swallowing (probably because the right side is so restricted in movement.
Is J Hughes the type to take me demonstrating this stuff in person by having him feel/listen to my throat as enough for him to consider surgery or is he going to insist it’s seen on a scan? I’m concerned as I rang to book an appt with him earlier and his secretary essentially said he doesn’t look at scans, he just goes by the radiographers report. If that’s the case they are just going to state it’s normal or they are unsure of the cause of my issues. Is that going to leave me at a dead end with Hughes or is he one thats more likely do agree to investigate surgically based on my symptoms?
Hi. You ask a tricky question. These are my thoughts based on my experience of Mr hughes.
He is an expert surgeon & a kind man who is concerned about his patients quality of life. You need to strongly advocate what effect your health problem is having on your life. He will physically examine you if you ask him to look at your neck problems close up. He has physically examined me in past visits when needed. My examples were explaining to him impact of complete inability to turn my head due to styloid compression. Also impact of higher brain pressures on right side of brain (but I did have Venogram pressure results to support this).
I find almost all medics rely on scan reports by radiologists with rare exceptions. This is a big problem as the radiology reports are not great. After I showed Me Hughes screenshot of styloid remnant I needed removed in revision surgery he told me he would look at the scans himself. Which I believe he did.
With high risk surgery (eg. Removal to skull base) they all want support to justify surgery. In my case he wanted consultant at Queens Sq to agree surgery was supported by him. That took a long time & delayed things for me.
So I am unsure on answer to your question, but if you do go then be prepared to advocate your case & explain impact on you. Good luck. D
I’ve not seen him, so can’t answer your question, but @Hema has seen him and he was prepared to do hyoid surgery for her. She’s still thinking about surgery, so if she doesn’t see this you could send her a pm. Good luck!
Hi @Callmestar1 . I’m new here and i hope you don’t mind me commenting. I also deal with the throat clicking, day in, day out. Going on three months now, so i totally understand your frustration. It is never ending, painful, and extremely disconcerting.
As yet, i have no solution from doctors or ENTs, so unfortunately can only offer my support at this stage. I have been told i have elongated hyoid bones, but have also been told SO many different things by different doctors. Two have told me it’s muscle tension due to anxiety or silent reflux. So i am on medication for both. My ENT also suggested anxiety medication (though i did have a breakdown in his office). I am working with a physio who specialises in myofascial release to see if that will alleviate the discomfort. I’m in discussion with speech pathologists to work on swallowing techniques and hyoid bone exercises.
I agree that the doctors don’t have much time for you. I think my ENT was about 6 minutes total. They push too hard and don’t feel the click. Then others look at you like you’re crazy because they’ve never heard of it. So it’s off for a second opinion i go…
I just wanted to say that i feel your pain. It is awful, and I’m sorry that you are going through it. I am in Australia, so please know that i am wishing you well in your quest for answers, from across the other side of the globe.
I tend to agree that it might be due to the muscle tension, as spasmed/short muscles can firmly push the hyoid bone backwards towards the spinal column (look for neck musculature diagrams I posted earlier on this forum). However, there might be many more causes of muscle spasm that than reflux, anxiety, or stress. Among the others, postural problems, excessive use of smartphone/laptop, and incorrect exercising (e.g. chin ups/pull ups).
Source: I used to have mild to moderate occasional clicking. My neck muscles used to be hard like rock, as I couldn’t move my neck without pain due to the long styloids. Styloidectomy helped to break this cycle and now I have been able to exercise neck muscles, so they are much more relaxed, longer, and softer (far from perfect though), and clicking is gone 100%.
@Callmestar1 do you feel your clicking at the back of your throat or at the front? Looking at your CT scans, there appears to be a short space between superior horn of the thyroid cornua and the hyoid bone. If you’re clicking is at the back, then that might be the issue. Can you see if you can measure this distance to see if it is within normal range? If your click is at the front of your throat, then i suspect that the thyroid lamina are more the issue. Calcification/ ossification of the thyroid cartilage happens over time, but is usually not complete until the late decades of life. I can see that your thyroid cartilage is visible on CT so i assume it has calcified regions. I have what i believe to be short distance between thyroid cartilage and hyoid bone, at 6mm in the location that clicks. I’m due to speak to a doctor next week to see if they think it could be the problem for me. This may be the case for your click also?
Thanks for you response. The thing is, the clicking in my throat doesn’t seem to be in only one spot. I’d say back right is probably the most prominent click but it varies. Often it’s at the back, sometimes at the front. Can be left side, can be right. Generally there just doesn’t appear to be enough space in there. My main concern is not the click, is the jammed/stuck upward pressure sensation at the back of the throat when I swallow.
Hmm, is it in different positions it makes different parts hit? Depending on which muscles are engaged at that time? My physio found one side of my neck muscles were not moving when the other side was. But it was a case of what came first, the restricted movement or the impinging structures. She said it was the body’s way of compensating and trying to protect the structures from hitting. Would that make sense for you? So the pressure sensation may be your body’s way of keeping your throat protected?