Clicking larynx syndrome-a diagnostic and surgical challenge

When swallowing, a clicking in the throat may uncommonly occur, causing great discomfort and pain. This unpleasant event may lead health professionals to attribute the symptoms to psychogenic aetiology. The case of a 49-year-old female is presented, who reported an audible bilateral clicking in the throat, associated with neck and throat pain when swallowing or turning her neck. From the ENT examination and palpation of the neck during patient swallowing, we located the source of the clicking on the left. However, during palpation from side to side, the patient suffered bilateral pain. Laryngeal computed tomography with a 3D reconstruction showed a short distance between the hyoid bone and the superior part of the thyroid cornua, accompanied by posterior-medially displaced bilateral superior cornua in the thyrohyoid region. The bilateral sensation of throat pain during swallowing or palpation, in combination with our desire to maintain laryngeal symmetry, led us to a two-sided exeresis of the superior thyroid cornua. This resulted in immediate and complete relief of the symptoms. Although it is an uncommon complaint, clicking larynx syndrome should be considered as a differential diagnosis. (c) 2020 Oto-Rhino-Laryngological Society of Japan Inc. Published by Elsevier B.V. All rights reserved.

Automated summary

A case of clicking larynx syndrome in a 49-year-old female patient was successfully treated with bilateral exeresis of the superior thyroid cornua, resulting in immediate relief of symptoms. The ENT examination helped to locate the source of the clicking and throat pain, leading to a successful surgical intervention to maintain laryngeal symmetry.