Superior thyroid cornu syndrome

Case contributed by Dr Mostafa El-Feky

Presentation

Dysphagia and difficulty in breathing.

Patient Data

Age: 40 years
Gender: Male
CT

CT Neck

Marked medial inclination of the right superior thyroid horn (cornu) together with the right greater horn of the hyoid bone. Consequently, the right thyroid-hyoid articulation shows marked medial deviation with its covering soft tissues and mucosa exerting bulge on the right side of the supra-glottic laryngeal airways that showed diminished caliber reaching 7.5 mm in diameter.

The oropharynx shows bulky palatine tonsils with tonsilloliths.

CT

3D

3D reconstruction of the thyroid cartilage that shows enlargement and medial deviation of the right superior horn of thyroid cartilage and the right greater horn of hyoid bone.

Case Discussion

This case represents symptomatic obstructive dyspnea and dysphagia due to partial laryngeal inlet obstruction by the enlarged and medially deviated right superior horn of thyroid cartilage and right greater horn of hyoid bone which is suggestive of the rare superior thyroid cornu syndrome. The patient performed endoscopy first to investigate dysphagia which didn't pass at the level of the hyoid bone. This syndrome may be congenital or secondary to old trauma.

Ossification of thyroid cartilage starts at the age of 20 to 23 at the inferior margin extending posteriorly at each ala, but the superior margin is never ossified 1. However, rare abnormal ossification of the thyroid cornu may cause symptoms like dysphagia, odynophagia, throat pain or foreign body sensation.

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Case information

rID: 58825
Published: 13th Aug 2018
Last edited: 3rd Jun 2019
System: Head & Neck
Inclusion in quiz mode: Included
Institution: Dar El Ashaa Center

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