Objective This study aimed to evaluate patients with anterior cervical pain syndromes (ACPSs) by describing patient characteristics, therapeutic interventions, and response to treatments. Study Design This is a retrospective observational study. Methods Patients treated for diagnoses associated with ACPSs over a seven-year period in one laryngology practice at a tertiary care center were identified and evaluated via a review of clinical and surgical records. Patients identified to have undergone any treatment for ACPSs via medication, trigger-point injections of local anesthetics mixed with steroids, and/or surgical resection of the greater cornu of the hyoid bone and superior cornu of the thyroid cartilage were included. Participants subsequently underwent a medical record review and telephone interview to determine response to treatments. Results Twenty-seven patients met the inclusion criteria, including 12 patients (44.4%) with superior laryngeal neuralgia (SLN), seven patients (25.9%) with superior thyroid cornu syndrome (STCS), and eight patients (29.6%) with hyoid bone syndrome (HBS)/clicking larynx syndrome. The most common symptoms were neck/throat pain (27, 100%), globus sensation (20, 74.1%), and dysphagia (20, 74.1%). A total of 24 patients (93.3%) underwent point injections of bupivacaine and dexamethasone. Of these, 12 patients (52.2%) demonstrated a complete response that was permanent in six patients (26.1%). Seven patients (25.9%) underwent surgical intervention, with at least partial improvement noted in six patients (85.7%). Conclusion ACPSs constitute a number of complex diagnoses that remain poorly characterized in the literature. The use of point injections of local anesthetics with steroids appears efficacious with surgical options available for those with an incomplete response or return of symptoms.

UNASSIGNED: When the superior cornu or the top edge of the thyroid cartilage rubs against the hyoid, or when these structures come to rub against the cervical spine, Clicking Larynx Syndrome (CLS) occurs. Which is a very rare disorder in that only less than 20 cases are reported in the literature. Patients seldom ever mention past laryngeal injuries. The cause of the accompanying pain when present is yet unknown. Gold standard management appears to be thyroplastic surgery in which the structures responsible for the clicking sounds are removed or reduction of the size of the large horn of the hyoid bone.
METHODS: Herein, we present a 42-year-old male patient with a history of papillary thyroid microcarcinoma treated with left thyroidectomy presented with a spontaneous continuous painless clicking noise and abnormal clicking movement of the larynx.
UNASSIGNED: CLS is a very rare condition with a very limited number of cases reported worldwide, most reported cases revealed abnormal laryngeal structural anatomy. However, our patient had normal laryngeal structures where multiple diagnostic tools (i.e.: Computed tomography, laryngoscopy) failed to disclose causative abnormality to explain his symptoms, nor literature could reveal any previously reported similar causes or explain the causative relationship between our patient\'s history of thyroid malignancy or thyroidectomy with his condition.
CONCLUSIONS: It is crucial to explain to patients with mild CLS that these clicking noises are safe and to provide them with information on the best possible case-dependent treatments to avoid the usually associated anxiety and psychological stress. Further observations and research are needed to analyze the association between thyroid malignancy, thyroidectomy and CLS.

Hyoid bone syndrome is a type of faciocervical pain and occasionally concomitant clicking larynx that is caused by degeneration and/or elongation of the greater horn of the hyoid bone at the attachment of the stylohyoid ligament.
We report five patients who presented with deep-seated, dull, aching, throat pain that radiated from neck, accompanying by throat clicking while speaking, swallowing, yawning, and turning head. Most notably, one of them also complained an intermittent ulcer hemorrhage in the tongue base. Diagnostic tests included physical palpation of the hyoid greater cornu and computed tomography examination. One patient did not accept the surgery, but other than that four patients responded well to resection of the abnormal hyoid bone, which resulted in immediate and complete relief of their symptoms and with no postoperative complications.
Clicking sensation and pain while deglutition is an unpleasant condition, which produces physiological and psychological bearings. This dictates the need for accurate diagnosis and proper management of the condition. Oral and maxillofacial surgeons involved in the treatment of orofacial pain should consider this rare condition as a differential diagnosis.

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.

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.