A case of clicking of the larynx and hyoid bone while swallowing

There have been reports of cases in which a clicking sound is produced in the neck region upon swallowing. It could occur because of elongation and thickening of the hyoid bone, resulting in its coming in contact with the cervical vertebrae during swallowing, or because of abutting of the thyroid cartilage against the hyoid bone, or even because of ossification of the space between the thyroid cartilage and the greater cornu of the hyoid bone. However, in all of these cases, the causes are different and also very rare. Herein, we report a case that we encountered in which a clicking sound was produced in the neck region because of both the thyroid bone and the hyoid bone coming in contact with the cervical vertebrae. The patient was a -year-old man. He visited our clinic, because one-year earlier, he had started to hear a sound when swallowing, which had progressively worsened. The abnormal sound was a click coming from the left neck region, and on CT, we observed elongation and hypertrophy of the left greater cornu of the hyoid bone. It was thought that the overgrowth of the hyoid bone was the principal cause, however, this could not be confirmed prior to the surgery. Surgery was performed under local anesthesia. First, the hypertrophic omohyoid muscle and sternohyoid muscle were cut, but the symptoms did not change. Upon cutting of the left greater cornu of the hyoid bone, which was thickened and slightly elongated, and came in contact the cervical vertebrae upon swallowing, the symptoms resolved somewhat. After cutting the superior cornu of the thyroid cartilage, which interfered with the cervical vertebrae upon swallowing, the symptoms disappeared altogether. This was an extremely rare case where the symptoms were caused by both the thyroid cartilage and the hyoid bone, however, appropriate treatment was given through surgery done under local anesthesia while the symptoms were concurrently assessed.