Abstract：
Globus sensation and pain causes are difficult to identify by conventional examination methods. With technology advances, new imaging methods including swallowing computed tomography (CT) and virtual reality (VR) have emerged and are contributing to definite diagnoses. We report two cases of cervical discomfort diagnosed as clicking larynx using swallowing CT/VR . Case 1 is a 55-year-old man. There were no findings on laryngoscopy or swallowing examinations, but swallowing CT/VR showed that the thyroid cartilage collided with the hyoid bone during swallowing, leading to the diagnosis of a clicking larynx. The patient was obese and is under observation hoping that weight loss will improve symptoms. Case 2 is a 32-year-old transgender man. He is receiving male hormones for gender identity disorder. He was diagnosed with a clicking larynx using swallowing CT/VR. Hormonal therapy may have increased the size of the thyroid cartilage, likely causing the symptoms. As they didn\'t choose surgical treatment, no symptomatic relief was achieved, but identifiying the cause contributed to improved patient satisfaction. Swallowing CT/VR is useful not only for evaluating the swallowing function, but also the underlying etiology of globus sensation and pain upon swallowing. Further clinical applications of this technique are expected for motion induced cervical symptoms.
摘要：
球感和疼痛原因难以通过常规检查方法来识别。随着技术的进步,包括吞咽计算机断层扫描(CT)和虚拟现实(VR)在内的新成像方法已经出现,并有助于明确诊断.我们报告了2例使用吞咽CT/VR诊断为点击喉的颈部不适。案例1是一名55岁的男子。喉镜检查或吞咽检查没有发现，但吞咽CT/VR显示吞咽时甲状软骨与舌骨碰撞,导致咔嗒声的诊断。患者肥胖，正在观察中，希望体重减轻可以改善症状。案例2是一名32岁的变性人。他正在接受男性荷尔蒙性别认同障碍。他被诊断为使用吞咽CT/VR点击喉。激素治疗可能增加了甲状软骨的大小，很可能导致症状。因为他们没有选择手术治疗,没有达到症状缓解，但是确定原因有助于提高患者的满意度。吞咽CT/VR不仅可用于评估吞咽功能，但也是吞咽时球状感觉和疼痛的潜在病因。该技术的进一步临床应用有望用于运动引起的宫颈症状。
