4.5 Article

Impingement of the Thyroid Cartilage on the Carotid Causing Clicking Larynx Syndrome and Stroke

Journal

LARYNGOSCOPE
Volume 132, Issue 7, Pages 1410-1413

Publisher

WILEY
DOI: 10.1002/lary.29956

Keywords

Larynx; neck; clicking larynx syndrome; stroke; thyroid cartilage; carotid impingement

Funding

  1. NY State Empire Clinical Research Investigator Program, Florence Gould Foundation for Discovery in Stroke
  2. Leon Levy Foundation

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A patient with recent history of ischemic stroke was diagnosed with clicking larynx syndrome, which was caused by unusual development of the thyroid cartilage leading to injury to the carotid artery. Surgical management resulted in symptom resolution.
We present the case of a patient with a recent history of ischemic stroke who presented with clicking larynx syndrome, a condition in which clicking noises in the larynx can be provoked by movement of the head and neck. Diagnostic imaging revealed unusual development and posterior angulation of the superior horn of the thyroid cartilage that potentially was causing trauma to the left common carotid artery. We deduced that symptomatic impingement of the carotid artery by the thyroid cartilage was not only the cause of the patient's clicking larynx syndrome, but also suspected to be the cause of her prior strokes due to repetitive trauma resulting in thrombus. The patient was managed surgically with thyroplasty and transcervical resection of the left greater cornu of the thyroid cartilage with resolution of her symptoms. Anatomical displacement of the thyroid cartilage can manifest as clicking larynx syndrome as well as cause mechanical injury to the carotid artery, resulting in turbulent flow, possible thrombosis, and stroke. Laryngoscope, 2021

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