Clicking larynx syndrome – a diagnostic and surgical challenge

Clicking Sensation on Swallowing

“…To our knowledge, no recurrence of symptoms has been reported in previous cases. [3][4][5][6] In conclusion, a clicking sensation on swallowing is suggestive of a clicking larynx, and a careful examination and SD-CT should be performed.…”

“…5 The major clicking locations are the superior cornu or the top edge of the thyroid cartilage, and the contact of these structures with the cervical spine occasionally causes laryngeal clicking sounds. 4,6 A decisive method to confirm the diagnosis of a clicking larynx has not been established because a clicking larynx often shows no abnormality on laryngoscopy, blood examinations, and radiography. [3][4][5][6] Although computed tomography can demonstrate that the distance between the hyoid bone and the thyroid cartilage is actually shortened or that they are in contact with each other, 6 it is difficult to detect the defining moment by a nondynamic test.…”

“…4,6 A decisive method to confirm the diagnosis of a clicking larynx has not been established because a clicking larynx often shows no abnormality on laryngoscopy, blood examinations, and radiography. [3][4][5][6] Although computed tomography can demonstrate that the distance between the hyoid bone and the thyroid cartilage is actually shortened or that they are in contact with each other, 6 it is difficult to detect the defining moment by a nondynamic test. In contrast, SD-CT provides precise, 3-dimensional dynamic images, enabling treatment-oriented evaluation of swallowing-related problems.…”

“…Surgery is the most effective treatment option for a clicking larynx. 5,6 It is usually performed under general anesthesia 6 ; however, we used local anesthesia because it allows for contact site identification during swallowing and helps confirm improvement in the physical contact by cartilage resection. Generally, symptoms improve immediately after surgery.…”

“…A thorough physical examination may provide diagnostic clues because the clicking location can be identified by palpation of the neck on swallowing . The major clicking locations are the superior cornu or the top edge of the thyroid cartilage, and the contact of these structures with the cervical spine occasionally causes laryngeal clicking sounds …”