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Click when swallowing

by blk133, Dec 01, 2007 08:15PM
Hello,

I was wondering if someone could help me.  For a few weeks now I have this click in my throat when I swallow.  Not when I am drinking water or eating, but just during normal swallowing.  It doesn't click when my head is down or up, but it clicks when I am looking straight.  If I put my fingers just above adams apple I can feel a click.

Please help me to identify what it could be.

Thank you,
B
Member Comments (54)

by blk133, Dec 11, 2007 01:44PM
To: Doctors
It has been 9 days since I made my post and not one response.  Was it just ignored or no one knows what it could be?

by Nancy T, Dec 11, 2007 05:30PM
I'm sure it's that no one has felt able to tell you what it might be or offer advice. It's frustrating to post and not get any responses (I've had that happen to me many times), but sometimes people really just don't know, especially about unusual symptoms. Please don't feel ignored.

Also remember this particular forum (ENT) is not an official ask-the-doctor forum where a doctor looks at and answers all questions. I do see there's one or two doctors posting here, as well as an audiologist, but they probably didn't know what to say either. Also, they may not be reading every question (everyone is limited in their time), only ones that pop out at them as ones they might be able to be helpful with.

I have no clue what could be causing your click. Try asking your doctor at your next visit (unless it's something that is hurting or really bothering you, in which case ask sooner), and ask for a referral to an ENT if the doctor can't help you.

Another thing you might try is reposting your question more specifically, i.e., "Click in throat when swallowing," in case someone sees it who knows more about throat issues but didn't open your question because they assumed it was a click in your ear. Might not make any difference--but you never know!

Best of luck,
Nancy T. (not a health professional)

by blk133, Dec 12, 2007 08:16AM
To: Nancy T
Thank you very much for you response and suggestions Nancy!

by Enoch Choi, MD, Dec 12, 2007 04:31PM
To: blk133
yeah, Nancy's right, I'm a doc and wouldn't be able to guess what that click is from.  Ask your doc to look down there with a mirror

An ENT has a laryngoscope that they can use to look down there

by blk133, Jun 20, 2008 09:51AM
To: Enoch Choi, MD
It has been more than 7 month and I still have this click, I went to ENT, did a video swallowing test and my ENT said that everything is fine.  I had tonsilectomy 2 weeks prior the click started and I feel that this click is the after cause of the surgery.  Of course ENT will say that everything is fine, because he is the one that did the surgery...  I keep touching my wind tunnel and pushing it with my fingers to the right, something clicks, then after I swallow next few times there is no click and then it comes back again.  Very tired of this clicking sound...  Don't know if it ever will go away.

by Nancy T, Jun 21, 2008 03:13PM
To: blk133
Bummer... sorry you still have this. Why not get a second opinion from another ENT?

Nancy T.

by jilldai, Jun 21, 2008 10:57PM
To: blk133
I am with you. blk133, I sent you an email. I have the same thing.  If anyone reads this and can help me and blk133, so be it. Where is HOUSE when you need him?

by jilldai, Jun 21, 2008 10:59PM
To: blk133
Sorry Ignore last post here is the oneI have seen three ENT's. I have had MRI contrast-negative, CT contrast-negative, and three laryngoscopies-all

negative. I will be doing ok for a few days (small amount of clicking and no pains) then I will have days where I

have the clicking, occipital headache on the affected side, pain deep in the neck where the clicking is (in the

triangle of the neck region at the level of Adams apple and below jaw), twinges of pain to my ear, jaw, and

sometimes teeth. This is all on the same side that is clicking, the right side. I have had no trauma to the neck, no

tonsils removed or surgeries. You mean no one in the medical field knows what is going on? This is crazy. The

third ENT I saw is a professor at a medical school. I am really frustrated and at a loss.

by milwaukee, Jul 03, 2008 02:02PM
To: blk133 and jilldai
I have the same problem and will see a specialist next week.

I didn't have any surgery in the area but I think I had an infection in the throat which caused high fever last year. It is all fine until recently I noticed the clicking when swallowing.

by cindy903, Sep 09, 2008 08:07PM
To: blk133
I have it now too. In addition, when I turn my head to the left or nod up and down a click occurs in the middle of my shoulders and the top of my neck near my head.

Going to an ENT.

I read that this unusual symptom was treated successfully at UCLA by a team of surgeons who took it on. They cured every person! They trimmed down bone fragments where it had been shattered during one surgery and thryoid muscle was trimmed for another. They had to isolate the clicking sound before performing the surgury. What lucky folks to have found a cure!

by blk133, Sep 10, 2008 07:08AM
To: cindy903
Good luck!  Keep us (clickers) posted

by cindy903, Sep 10, 2008 06:28PM
To: blk133
An excellent ENT believes it's STRESS related similar to globulus histericus or some such thing. Interestingly, after being reassured it went away for the rest of the day.

Did the test down the nose, which must be their gold standard test for ENT docs. He is excellent and has an excellent bedside manner. He really listened and has the gift of persuasion as well. I'm hopeful that it is stress.

Dinner time was frustrating as heck though so I'm not so sure. He said see him in two months as a follow up to the syndrome but he's so popular I can't get in until January 09. Maybe I'll be cured. Either way, he wants to see me. "Clicky Throat Saga" to be continued...

by cindy903, Sep 25, 2008 05:06PM
To: blk133
Click still there. Going to have ultrasound on thyroid tomorrow.

Bet it's not related.

Recently diagnosed with Lyme.

I bet it's related to that. My neck snaps, crackles and pops and since my esophogus is near my neck, well, it just joined in the fun.

by blk133, Sep 26, 2008 07:23AM
To: cindy903
:(  I thought he cured you by telling you that it was stress.  I was told that it could be a thyroid that's causing this click as well, but I never checked it.  
Let us know your results...

by cindy903, Oct 01, 2008 07:26PM
To: blk133
Results of thyroid NORMAL!  I was hoping that was it -- even though I hate bad news, I'd take it over not knowing why I awakened one day to not only neck popping like mad, but my throat!

I believe the ENT that said it was "throat crepitus" or globulus hystericus. It turns out is is most likely crepitus At least globulus hystericus is curable. My clicky throat is possibly related to what was later a diagnosis of Lyme. Am still seeking answers regarding LD and hopefully with the right treatment the "crepitus" will resolve in my throat and neck as well.

It ain't pleasant this throat click thing. Popcorn does not go down very smoothly!

by blk133, Oct 29, 2008 12:11PM
To: cindy903
Hey Cindy,
how's your click?  Is it any better?  About 4 days ago my sholder started to hurt and my wife asked me to take advil, so for a 3 days in a row I was taking 2 pills in the morning, I think when I take Advil my throat doesn't click as often.  It doesn't disappear completely, it still clicks here and there, but not as much.  Do you mind taking Advil for a few days in a row and see if it helps you as well?

by cindy903, Nov 08, 2008 10:33AM
To: blk133
I can try Advil. If it's an NSAID, I'm not surprised it works. Will let you know.

I am being treated for LD afterall. Bummer diagnosis since there's no cure.

by wildblue98, Dec 06, 2008 07:15PM
To: blk133 and jildai
Your problems sound exactly similar to mine, I have been diagnosed with a larngeal abnormality after an injury in which the superior cornu of the thyroid cartilage is rubbing against the hyoid bone, I had occipital headache, jaw and ear pain and crepitus when I rotate or press in on my throat, clicking with swallowing is a treatable condition if you search the medical literature, I am actually getting surgery at UCLA for this condition. See the forum on hyoid bone problems on this site and you will see a plethora of information regarding your possible conditions, what doctors know, and how to treat.

by Thndr800, Jan 01, 2009 07:48PM
To: blk133
Exact same thing for me blk133.  I also had my tonsils out and now I notice this annoying clicking on my right side.  I've been experiencing all the same symptoms.  Clicking when swallowing saliva but not eating or drinking.  Seems more prominent when my head it turned to the right instead of left. MY ENT who performed the surgury seems to feel that it's the Hyoid bone rubbing against a gland or tendon but could not answer why other than an automical abnormality.  I was taking Tylenol and it seemed to help a little as well. A couple of drinks also seems to relieve the symptoms 99% but always comes back the next morning. Guess I'll have to stay drunk!! I also found solutions on a couple of other sites  that I will try.  One sufferer said that she tried favoring the side that did not hurt for a week while swallowing and the pain went away after about a week. I guess it's the analogy of staying off a sprained ankle to let it heal. The other person performed neck excercises recommended by a physiologist.  He said the excercises completely resolved the clicking after 4 days of excercising.  Too bad he didn't leave instructions.  Anyway I'll let you know how I make out.  Please let me know if any of you come across other solutions or things that may have worked for you.

Good luck

by cindy903, Jan 11, 2009 02:30PM
I think it's annoying as &*(%. It sort of comes and goes, but mostly is here to stay. UCLA will do some kind of outpatient procedure that cures it.

My click is like a thump. Or it feels like my esophagus is too narrow to swallow.

Maybe it's the Lyme. You know the disease that doesn't exist, and there is no cure or test to confirm it.

My neck clicks whenever it's turned as well. Sometimes my jaw clicks making eating noisy.

by wildblue98, Jan 26, 2009 02:11AM
To: wildblue98
i know its so annoying ruining my life

by wildblue98, Jan 27, 2009 11:49PM
I am also wondering if this clicking in the throat with head rotation can effect the jaw positioning because my jaw started clicking ocassionally  too ever since I got this and its hard to yawn

by pinkydinkydoo89, Jan 28, 2009 12:27AM
To: blk133
hello...yea tmd (or as most people call it tmj which is only the bone rather than the actual condition)...well yea it *****.
i got my wisdom teeth cut out almost 1 1/2 ago and the left side of my jaw has been popping ever since. every time i open my mouth it pops...kinda hurts but i would say the migraines are worse. i get 2 almost every month. i lose all of my periphial vision in my left eye each time for about an hour before the actual migraine...it really *****
if you havent seen an ent you should

best of luck :)

by blk133, Jan 28, 2009 07:35AM
To: pinkydinkydoo89
I don't have any problems with my jaw so far, it's the person above your post has it.  But I still have the click in my throat.  Now that I've seen some images of throat on the internet I can tell that my click is right where they hyoid bone is.

by wildblue98, Jan 29, 2009 12:22AM
To: wildblue98
Interesting I also had a pretty radical wisdom teeth procedure done a couple years ago under general anasthesia they went in and cut out all four fully impacted teeth, dont know if that has something to do with it. Thanks for the info.

by wildblue98, Jan 29, 2009 12:25AM
To: blk
The clicking above the adams apple may be an  elongated or displaced superior cornu thryoid cartilage rubbing on the hyoid/transverse process thats what it was for me and it showed up on nuetral head turn CT scan. Hope that helps.

by blk133, Jan 29, 2009 08:06AM
To: wildblue98
so after you found out about the displaced superior corn........  what did you do about it?  I mean your click is still there, can doctors do something?  Yesterday I went to the dentist and after she did the shot to make my lower right side of the jaw numb that "drug" made all my muscles in the throat very tight, it even was hard to swallow, but while my teeth, bottom lip and tongue were numb, the click wasn't there.  Go figure...

by wildblue98, Jan 29, 2009 09:06PM
To: blk133
Well in my case the problem is from an elongated supeior cornu hitting the transverse process ( it is usually and elongated cornu hitting the hyoid or transverse process that creates this throat click), the surgeons think they can fix and have fixed it in the past  by trimming off the end of my superior cornu so it is not comming in contact with the transverse process. It makes sense that the clicking might stop temporarily from increased muscular tension, I too have noticed that. Thats because the tense muscles help hold the cornu in position temporarily. But its been over a year and my click is still there so I just decided to go ahead with the surgery since it is a very structurally apparent problem. I think the surgeons are right and once those two structures stop hitting eachother the clicking and inflammation will subside.  The only people I have found who know a lot about this condition are at UCLA. I also know their is a team in Utah, and a doctor in Swansea, Wales with published research on a displaced cornu. Hope this helps.

by pinkydinkydoo89, Jan 30, 2009 12:09AM
To: blk133
o ok. i see . sry

by chizzad, Mar 04, 2009 11:41AM
To: wildblue98
Hello,
       I am having very similar symptons,  was wondering if you had any more info on the team in Utah?  Names which hospital would be very appreciated!!

by OuchStomach, Aug 31, 2009 10:59AM
I have all this too! Plz help!  Started 3 weeks ago after a minor cold.  A click/pop/thump when I swallow.  Not all the time and usually spit swallowing only.  Seems to happen when my adam's apple is at its highest on a swallow.  I also feel like there is something in my throat on the right side.  No ear pain, no jaw pain....but my tongue gets a little weird sensation.

I was in a car accident 4 years ago where my head went through a windshield, but this is new to me.  I recently had a cold, and I think my lymph node on the right side under my chin is a little swollen (could be from cold).

Very scary.  I read about this popping above the adam's apple and the big bad C word came back.  Going to ENT tomorrow, I hope they give me the same results as everyone else thats its nothing, or something simple and easy to treat.

by lilly945, Sep 30, 2009 09:01AM
I found this and it helped right away!!

"Best Answer - Chosen by Voters
when you feel the clicking get the palm of you hand rest it on your cheek (same side as the click) and gently pull your facial skin / muscles upwars towards your ear. Do it in a way that your palm runs up along your jaw line.

Other than that see what your chiro says"
1 month ago

by unlazyboy285, Oct 01, 2009 10:28PM
I have this too!  Except mine comes with a few other symptoms.  I only have it on the right side of my throat and it only happens when my head is turned a certain way.  My right lung also hurts sometimes, and I have so get strange headaches on random parts of only the right side of my head, as well as pain in my right trapezium.  Any help is greatly appreciated!

by silvercat1, Nov 08, 2009 03:56PM
To: blk133, wildblue98, cindy903, thndr800, jilldai
Part 1 of 2.

I also have similar click swallow (and some other) symptoms as some of the posters especially blk133 and cindy903 and wildblue98, thndr800, jilldai. The symptoms have significantly ruined the quality of my life since early 2007. So far, I have not been able to find a definitive diagnosis or a cure or reduce or control the symptoms. I can fully empathise with the posters who have this or a similar condition and welcome those who would wish to swap experiences, ideas, partial or full remedies.  I would love to know of anyone who has obtained a confident diagnosis and cure.  I am new to the post so have not seen many of the posts except the thread starting from blk133’s post starting from Dec 1 2007.

Symptoms present:
Click on dry swallow, that fades or disappears on second, third swallow.
Sometimes the click is still noticeable when swallowing liquid or solid food.
When the click has gone after a swallow, the click can be made to return with significant magnitude immediately after clearing throat or a hard cough (to clear throat) and immediate dry swallowing (dry swallowing = with no food/liquid except saliva).
Very mild dull pain a second after swallowing – pain located in the upper oesophagus.
Some feeling of aspiration of fluid? at entrance of windpipe causing occasional need to clear throat, cough. After coughing, click swallow can be abrupt.
Sensation of something stuck in lower throat (below Adam’s apple and level with where the neck joins the chest, and a feeling of something stuck in the upper part of the oesophagus).  
Occasional production of phlegm but not frequent.
Dry retching. The globus sensation of something stuck is not always present but when present, causes periods of retching to the point of violent choking. The retching episodes are short bursts of a few seconds and can occur once or several times a day, but not every day. The retching frequency slowly builds up over a period of several weeks where the frequency of retching maximises then subsides after violent retching.

I cannot correlate the throat click or the globus sensation or retching with anxiety for these symptoms can occur with significant intensity at times of reduced exposure to stress, e.g. when on holiday, doing pleasurable leisure activities, resting.

Symptoms absent: (I include “symptoms absent” here because it may help doctors and other readers to eliminate potential conditions rather than just indicating the existing symptoms): Heartburn, indigestion, burning sensations from acid reflux [if acid reflux is present, it has to be silent reflux.  Several months of PPI have no effect, whether I take them or not. On that basis, I would have thought if acid reflux was the cause of the symptoms, PPI would have curbed or eliminated it, but they haven’t.  A hiatus hernia was observed but both nocturnal and daytime (upright) abrupt liquid reflux is absent].
Weight loss absent.  Regurgitation absent. Sore throat and bad breath absent.
No evidence of acid reflux effects on teeth confirmed by dentist (although not a 100% diagnostic indicator of the absence of acid reflux).

The click swallow started after a gastroscopy (oesophagogastroduodenoscopy OGD) in Mar 2007. During the procedure, under normal sedation, I started to choke on the scope fully inserted. This was not the normal gagging reflex expected of some people having an OGD but rather a violent choking. Whilst on the table choking, I was knocked out completely with an additional, heavy dose of sedation.  I awoke later in the recovery ward.  It was not a case of amnesia of me “thinking” I had been knocked out because I couldn’t remember, - the additional mid procedure heavy dose of sedation was stated on the report.  I’ve had the click swallow ever since.  The purpose of the OGD was to look for the presence of a foreign object in my throat causing retching.  I had suspected a tooth brush bristle because my tooth brush had been loosing a few bristles and a couple had got caught in my mouth whilst cleaning teeth. I thought that an unnoticed bristle may have been partially swallowed and became lodged in the larynx or oesophagus as this retching came on suddenly overnight. No bristle was found though a colourless bristle is quite a small object to see.

Prior to the OGD, two months earlier, I had swallowed a small piece of soft cooked chicken.  Severe painful stomach spasm hiccups started which resulted in vomiting colourless fluids over a period of several hours.  I rested and recovered over the next 1-2 weeks.  10 days later, retching started suddenly and unexpectedly and took me by surprise. This lead to the OGD two months later after 2 months of intermittent retching where at times I was frantic with the sensation of something stuck and causing involuntary retching.

I have found a number of medical papers that indicate arytenoid dislocation and subluxation (AS) as rare laryngeal injuries usually thought to occur as complications of upper aerodigestive tract instrumentation.  One of the posters to this forum referred to corniculate subluxation. “Arytenoid dislocation refers to complete separation of the arytenoid cartilage from the joint space.  It usually results from severe laryngeal trauma. Arytenoid subluxation is likely a lesser injury and refers to partial displacement of the arytenoid within the joint.”  Patients with AS present with hoarseness; breathy vocal quality, vocal fatigue. But dysphagia, odynophagia, sore throat and cough are less common. (ref  Arytenoid Dislocation.  Joshua S Schindler, Yvette V Leslie, Jan 27, 2007. http://www.emedicine.medscape.com/article/866464). Unfortunately since I obtained this document, the link I provide doesn’t seem to work directly to the paper itself but takes you to the proper web site. Searching it from the web site given the authors and title resulted in a registration page.

see part 2

by silvercat1, Nov 08, 2009 03:58PM
To: blk133, wildblue98, cindy903, thndr800, jilldai
Part 2 of 2.
Although I have been seen by an ENT earlier in the year, I am unsure whether such subluxations/dislocations can be seen with a visible ENT nasendoscope - (if that’s the cause of my click swallow?) – can anyone say? The paper referenced above indicates that a thorough laryngeal exam should be performed. Whether the ENT’s “less than 15 second view”, would be regarded as thorough I am unsure – perhaps someone could say to compare?  In my view, although disappointing because I myself put a lot of dedication and detail into my own work as a scientist, this particular ENT’s body language told me he wasn’t interested and he said he couldn’t do anything for the click, then sent me on my way to continue with the debilitating symptoms.  

I do have some hoarseness but it is intermittent, possibly related to coughing (and all my life I have never been a cougher except for during colds/flu and even then it was limited). But I am told by relatives and friends that my voice has changed to a more gravely sound, although this may be because on those occasions when they listen, the throat needs to be cleared frequently and the sound may be due to interference from fluids/secretions that need to be moved out of the way of the vocal chords?

The other paper which describes a cause of foreign body sensation in the throat is “ Foreign body sensation in the throat due to displacement of the superior cornu of the thyroid cartilage: two cases and a literature review”  SK Nadig, S Uppal, GW Back, AP Coatsworth, AR Grace. J. Laryngol Otol, 2006 July; 120 (7): 608-9. Epub 2006 May 9.  I only have the abstract of this paper, which is available free on the internet.
Search at http://www.ncbi.nlm.nih.gov/pubmed/12649827.  I intend to buy the paper.

There is another relevant paper, which I do not have except for the abstract:
Clicking in the throat: cinematic fiction or surgical fact?
Smith ME, Berke GS, Gray SD, Dove H, Harnsberger R.
Division of Otolaryngology-Head and Neck Surgery, National Center for Voice and Speech, University of Utah School of Medicine, Salt Lake City, UT 84132, USA.   Arch Otolaryngol Head Neck Surg. 2001 Sep;127(9):1129-31.


I have also come across a paper which describes a physical cause of globus pharyngeus where the epiglottis tip is curled backward towards and touches the base of the back of the tongue causing the sensation of a foreign body.   Earlier this year, I first noticed my epiglottis sometimes becomes visible above the horizon made by the back of the tongue. This sometimes appears when clearing the throat but before swallowing. On swallowing, there is a click then the epiglottis disappears.  I don’t know if I am choking on my own epiglottis or if it is unrelated. I only started seeing the epiglottis two years after the problems began and I had been looking into my throat since Jan 2007 and had never noticed the epiglottis before.  Does anyone know if it is possible for an epiglottis to become stretched or dislodged from its normal “equilibrium” location as a result of a problem (such as dislocation) of the structures in the larynx that are eventually connected to the epiglottis?  I don’t know if the epiglottis can eventually start to appear due to arytenoid subluxation or corniculate cartilage subluxation?


For me, the two problems may be related or unrelated: Click swallow has been present all the time since the gastroscopy in early 2007.  
Sensation of something stuck in the lower throat/and or beginning of the oesophagus or trachea occurs intermittently, and can cause periods of debilitating retching and choking.

Some questions to ask readers or to provoke further discussion and sharing of knowledge:

1. Is it possible that the click swallow has been caused by the throat clamping down on the gastroscope during the difficult gastroscopy? or, the retching?
2. Can a gastroscopy which involves choking actually cause a hiatus hernia e.g. caused by pumping air into the stomach causing abrupt rises in stomach pressure due to choking and coughing during the procedure? I ask this question because I did not have a hiatus hernia at all 14 months before the gastroscopy so it had just occurred in that interim period or during that one bout of vomiting or during the gastroscopy?
3. Is it possible that for a patient taking PPI, that acid reflux can still occur but yet not cause any indigestion or heartburn or burning feelings, but that such acid could cause oesophageal spasm that could be the cause of click swallow? My personal feeling is that PPI should completely halt acid reflux and pH would be controlled such that if any tiny amount of acid leaked during the night, its pH would not be so aggressive to cause oesophageal spasm interfering with the swallowing contractions. I want to rule out acid reflux as a potential cause of click swallow. Personally, I believe my click swallow is a mechanical physical problem with one or more cartilages in the larynx.

I have found bronchial mixture to be of some temporary relief of throat sensations. However, this is probably due to the temporary local anaesthetic effect, which after it wears off, symptoms are still present.

I wish all those who have click swallow, good luck in finding remedies. I’d be interested to hear from you.

I have needed to put this post into two parts, but thought that the references provided would be of use.



by wildblue98, Nov 10, 2009 01:13AM
To: silvercat
I find your medical information very interesting as I recently underwent surgery at UCLA for a clicking noise in my throat. In my case the clicking in the throat was occuring every time I turned my head and was from the elongation of the superior cornu of the thyroid cartilage. The very article you intend to read: Clicking in the throat: cinematic fiction or surgical fact?
Smith ME, Berke GS, Gray SD, Dove H, Harnsberger R.
Division of Otolaryngology-Head and Neck Surgery, National Center for Voice and Speech, University of Utah School of Medicine, Salt Lake City, UT 84132, USA.   Arch Otolaryngol Head Neck Surg. 2001 Sep;127(9):1129-31.

Well, believe it or not my surgeon was one of the authors in this article who is familiar with the clicking throat condition. In my case they were able to get rid of the clicking of the thryoid cartilage against the tranverse process every time I turned my head, unfortunately I also have a clicking greater cornua of the hyoid bone that must be operated on now. I find your case interesting though because it reminds me a lot of the sufferers in the "clicking throat article" who had their symptoms come on from surgical intubation. It sounds like you very well may have injured part of your thyroid cartilage which is clicking against a nearby structure either the hyoid bone or tranverse process. There are other things that could cause a click it really depends on the region you are feeling it but from what I have read in the medical literature it seems that clicks from swallowing are most common due to thyroid cartilage abnormalities rubbing against the hyoid bone or tranverse process. The way you describe the onset of yours reminds me of the elongated superior cornua thyroid cartilage sufferers mentioned in the "clicking throat study". If you provide me an email address (message me) and I will be glad to email you the article I have it saved on my computer.

by wildblue98, Nov 10, 2009 01:16AM
To: silvercat
For me, the two problems may be related or unrelated: Click swallow has been present all the time since the gastroscopy in early 2007.  
Sensation of something stuck in the lower throat/and or beginning of the oesophagus or trachea occurs intermittently, and can cause periods of debilitating retching and choking.

Clicking in throat is often times accompanied by foriegn body sensation in the same area. This is extensively documented in the medical literature.

by paladinx5, Nov 10, 2009 11:57AM
I have had a throat click for quite some time. its like a clicking sound almost like bones are bumping together it is painless.  I can also swallow and not make the click.  I dont feel anything really.   it has not really bothered me so I have just ignored it.  its almost like I can control whether it clicks or not.   I have a feeling its probably something harmless something with the bones and cartilage of the atoms apple rubbing together

by wildblue98, Nov 19, 2009 06:20PM
To: all
There are some abnormalities that can cause "clicking" in the neck and face. One of the most common is temporo-mandibular joint dysfunction. This is a problem of the jaw joint that can cause jaw, ear, and neck pain. From the history given, this is not likely here. The hyoid can also cause a neck click. This was evaluated with a CT that showed normal hyoid anatomy by report. One more cause is the thyroid cartilage (the main cartilage of the larynx) rubbing against the cervical vertebrae. Usually, it is the superior cornu (horn) that rubs against the transverse process of the cervical vertebra. During normal swallow, the larynx is lifted towards the back of the tongue. This is when the "click" happens. It can be hard to detect, especially if not suspected first. The cartilage is hard to see on x-rays (and in swallow studies with fluoroscopy), because it is not usually calcified at it's superior end. It could have been caused by trauma to the larynx. A CT can sometimes show a posteriorly displaced superior cornu. It can be treated by surgically removing the displaced piece of cartilage. An otolaryngologist with interest in swallow dysfunction (sometimes with specific training in laryngology--voice problems) may be able to help. Again, it can be hard to prove that this is what is causing the click. Any surgeon should be cautious about going to surgery without a definitive diagnosis, and the patient must be prepared to have a procedure that may not help the problem.


Michael J Wolfe, MD
Assistant Professor
Department of Otolaryngology
College of Medicine
University of Cincinnati

by nucleardave, Nov 19, 2009 06:21PM
I've had a similar click in the throat when swallowing for almost 20 years now. Over the years I've seen a few different ENTs who have all told me it is nothing to worry about. It still bothers me somewhat, but not as bad as it used to - I think I've gotten used to it, kind of had to.

In my case, it clicks on the left side when I swallow unless I turn my head to the left or tip my head way back - if I turn my head to the right or tip my head down, the click is even worse.

Mine started after I had a really bad sore throat, but who knows, that may have just been a coincidence.

Since I've had it for ~20 years, I know it isn't anything too serious, it hasn't gotten noticeably worse, but I'd still like it to go away.

If anyone else is able to cure this (ideally without surgery) I would be very interested in how (even if it was surgery).

by esssf, Nov 23, 2009 07:18PM
Hi wildblue98, i am having this problem to it is above my adams apple near the top of my throat you can say.

Everytime i swollow this clicking is here and ever since it came i started getting tonsilitus so i went to the ENT and he told me it was probally the tonsils causing it..

Moving on.. he told me to get my tonsils out so i did but the clicing is still here what  can i do about this im getting worried i think theirs something wrong in my throat please get back to me.


By the way ive seen 3 ENT`S and they told me its nothing to worry about but the thing that concerns me is ever since this clicking started i started getting tonsilitis all the time now my tonsils are out its still here (THE CLICKING)

by esssf, Nov 23, 2009 07:22PM
I also forgot to mention when i drink water, etc it doesn`t click but now i am getting worried about this because i no their is somethng wrong COULD SOMEONE REPLY ANY1.

by wildblue98, Nov 28, 2009 04:41AM
To: ALL
There are some abnormalities that can cause "clicking" in the neck and face. One of the most common is temporo-mandibular joint dysfunction. This is a problem of the jaw joint that can cause jaw, ear, and neck pain. From the history given, this is not likely here. The hyoid can also cause a neck click. This was evaluated with a CT that showed normal hyoid anatomy by report. One more cause is the thyroid cartilage (the main cartilage of the larynx) rubbing against the cervical vertebrae. Usually, it is the superior cornu (horn) that rubs against the transverse process of the cervical vertebra. During normal swallow, the larynx is lifted towards the back of the tongue. This is when the "click" happens. It can be hard to detect, especially if not suspected first. The cartilage is hard to see on x-rays (and in swallow studies with fluoroscopy), because it is not usually calcified at it's superior end. It could have been caused by trauma to the larynx. A CT can sometimes show a posteriorly displaced superior cornu. It can be treated by surgically removing the displaced piece of cartilage. An otolaryngologist with interest in swallow dysfunction (sometimes with specific training in laryngology--voice problems) may be able to help. Again, it can be hard to prove that this is what is causing the click. Any surgeon should be cautious about going to surgery without a definitive diagnosis, and the patient must be prepared to have a procedure that may not help the problem.
There are some abnormalities that can cause "clicking" in the neck and face. One of the most common is temporo-mandibular joint dysfunction. This is a problem of the jaw joint that can cause jaw, ear, and neck pain. From the history given, this is not likely here. The hyoid can also cause a neck click. This was evaluated with a CT that showed normal hyoid anatomy by report. One more cause is the thyroid cartilage (the main cartilage of the larynx) rubbing against the cervical vertebrae. Usually, it is the superior cornu (horn) that rubs against the transverse process of the cervical vertebra. During normal swallow, the larynx is lifted towards the back of the tongue. This is when the "click" happens. It can be hard to detect, especially if not suspected first. The cartilage is hard to see on x-rays (and in swallow studies with fluoroscopy), because it is not usually calcified at it's superior end. It could have been caused by trauma to the larynx. A CT can sometimes show a posteriorly displaced superior cornu. It can be treated by surgically removing the displaced piece of cartilage. An otolaryngologist with interest in swallow dysfunction (sometimes with specific training in laryngology--voice problems) may be able to help. Again, it can be hard to prove that this is what is causing the click. Any surgeon should be cautious about going to surgery without a definitive diagnosis, and the patient must be prepared to have a procedure that may not help the problem.

(I think this answer from the below MD applies to essf and nuclear dave)

Michael J Wolfe, MD
Assistant Professor
Department of Otolaryngology
College of Medicine
University of Cincinnati

If you have clicking in your throat the best surgeon I know for problems in this area is Dr. Gerald Berke Chief Surgeon of Head and Neck Surgery at UCLA medical center. He operated on me and cured a click I had every time I turned my head that was due to an elongation of the superior cornu thyroid cartilage. If it really bothers you I would seek treatment.

by esssf, Nov 28, 2009 06:45PM
To: wildblue98
Thank you so much for replying to me what i was wondering is this life threatening by any chance it really worries me, when i turn my neck, right the clicking wouldn`t be their its only their when my head is straight and when i turn my head left.

Its basically where the hyoid bone is.

Thanks again for taking time to reply to me much appreciated.

by batlife, Nov 30, 2009 01:01AM
To: ALL
Ive had this for five months.. Been 2 ENT's n they havent found anything.. My throat started clicking after extreme pain while yawning.. i felt like i tore something..My voice has chnged also.. im not able to sing, whisper.. i also feel like im tlking out of the right side of the mouth.. the click is in the left side of my throat.. everyone thinks its mental..  is it possible tht i damaged my laryngeal nerve.. because im also having trouble breathing.. im lost with this

by silvercat1, Nov 30, 2009 06:51AM
To: batlife
Hi
Don't know what it could be, but seeing as it started suddenly coinciding with some physically traumatic event (the painful yawning), I can't see how anyone can say it is mental.  It annoys me how people can label se easily without considering or knowing of all the relevant facts. From the forums I've read, even some ENT's suggest psychogenic/psychosomatic causes for various problems in the throat in the absence of seeing anything from a visual exam. Yet, in many of the cases I've seen, they seem to coincide with an event that involved some kind of trauma. I don't mean mental trauma, but rather, physical trauma where the potential for temporary of permanent changes in the physical structures might have occurred. E.g. a change from a normal throat environment to another environment where strucures now touch, or rub against each other, causing sensations that were not there before. Who knows, frictional rubbing might cause irritation that wasn't there before, etc etc.

When you go about a leg injury to a sports person, or a physiotherapist, how many times have you ever heard them say, "I can't see the injury in your knee joint, therefore I'm concluding that it is "in your head" it's mental"?  I would bet NEVER.  So why do some ENT make suggestions of mental causes?  

There may be some unique symptoms associated with laryngeal nerve damage, and if so, if these were not present, it might help to rule out laryngeal nerve damage. Some doctors might say.  I'm not a doctor but I would guess or assume that larygeal nerve damage is unlikely without severe trauma to the larynx. Wildblue is good for knowledge and he may well answer your question much better than me.

I assume you asked that question to the 2 ENT you saw?

Some speech or voice coaches might be able to answer your question and also help to provide some exercises that might help.

A recent friend had her neck badly strained and she had mentioned a technique called Bowen technique or treatment. I don't know what it involves, but I think it was of some benefit to her on a previous occasion unrelated to her neck and she is considering having same treatment on her neck.

There could be a number of reasons for changed voice, but one condition that I have read recently which involves a hoarse voice, is arytenoid dislocation. But I think that this can be seen on a normal ENT exam, so the ENT's have probably ruled that out.








by esssf, Nov 30, 2009 03:44PM
To: silvercat1,
I remember the day this clicking had appeared 7 months ago.

Ever since this clicking appeared i starterd to get sore and tonsilituss atleast 2 times a month at some stages i was forced to go in hospital because i couldnt swollow.

Moving on i saw Atleast 4 ENT`s and 2 of them told me it was possible that the tonsils are causing it because they are inflamed, another 1 and said it could be something to do with my voice box but i havn`t noticed any change in my voice what so ever. Finally the final 1 had said to me its all in my head and to me that was out of order because the clicking is really going on.

Soo, i went back to the same ENT and he had said to me he will arange foirr me to get my tonsils out.....

19th of november 2009 i had the surgery (2 weeks ago) The clicking is still here and has only got worse.

I don`t know what to do no more it is ruining my life and im sick and tied of these ENT`s because the way they act in terms of body language i can clearly see they don`t give  a shi*....

The only thing that worried me was when it started i started getting tonsillitis.

Any ideas.

Thankyou Essa.

by esssf, Nov 30, 2009 03:45PM
To: All
The question above is to anyone that knows anything please get back to me Thanks.

by silvercat1, Dec 01, 2009 06:07AM
To: esssf
Essa

I cant understand why an ENT would suggest tonsils as a cause of clicking. They are soft tissue, so it's hard to understand how a click could occur on swallow. Perhaps unless the tonsils were so swollen and enlarged that the swallow mechanism results in the tonsils being squeezed with the "sensation" of a click happening. Or they contained tonsiloliths making them more firmer?

When I read your note on getting tonsils out, I would have said don't. But, you have had a lot of tonsilitis from what you say and some ENT would say remove them whilst others would say don't, they are a defense mechanism. But if they are so over worked, then to avoid further infections, some may suggest removing them.

It seems only 2 weeks ago since surgery so your body may not have settled down yet. There may still be some swellings.

One thing i can say is that when we develop these things, we tend to become hypervigilant - what I mean by that is, start to notice sensations that were always there but your subsconscious ignores those sensations and treats them as normal body functions. Then we start focussing on the throat and perhaps start to wonder, was that squelchy noise or gurgle there before or has it just started now?

The click is truly there in you and yes, I've had the body language from one ENT who I thought could have had a better bed side manner.

Perhaps take it step by step. Allow time for your body to settle after surgery, so that that variable is removed. Then see what the magnitude of the click is like then.

I agree about it ruining your life, the symtoms I have developed (retching, globus, click swallow) have ruined parts of my life because it can be debilitating - especially retching and globus which sometimes makes me feel close to retching.  Perhaps try to focus on something complteley different. Give your mind and body a rest and force yourself to do some leisure activities so that it will distract you from concentrating on the sensations, where you might? develop a desensitisation to the sensations.  Think like when you have a headache, or pain in a joint - we don't usually focus on it, but we accept that they are there, then take painkillers or not, then later, headache is gone and days later, you might say, oh, that joint ache has gone now, I had forgotten I had that. May be a try?



by esssf, Dec 01, 2009 08:44PM
To: silvercat1,
silvercat1,

Thankyou for your quick reply.

I mean my thorat has completely healed i can swollow and everything looks ok however to me this clicking has only got worse i mean if i turn my head left or keep it striaght the clicking will be there whenever i swollow.
Now if i turn my head left, upwards, down the clicking wouldn`t be there.

Personally me i think it is something to do with my hyoid bone reason for that is because the clicking goggling sound is basically where the hyoid bone is.

The thing that had me worried, (as i explained before) Ever since this started i started to get alot of infections on my tonsils so the ENT dicided to remove them as i kept getting tonsillitis and white patches on the back of them.

I did question him before the surgery and i asked him what do you think is causing the clicking he had replied by saying that it could be inflammation.

ENT 2: had said it could be something to do with my voicebox this was when i had been taking in to hospital due to the white patches on the back of the tonsils.

ENT 3: had said its nothing to worry about its just all in your head which i found out of order.

I mean i am going to book another appointment with my G.P and arrange for him to send me to another ENT for the 5th time, this time i am actually going to have a go at them.

As you said i should keep my mind of it by doing activities. I go to the gym 5 times a week and study so my mind is of it what i want to know is do you think it is anything to worry aboout?

Thanks for replying to my other question hope to here from you soon.

Essa,

by esssf, Dec 01, 2009 08:49PM
By the way i am a young Male 18 years old and im stuck with this.

I just don`t know anymore.

by wildblue98, Dec 02, 2009 04:47AM
To: esssf
While statistically speaking just from combing through medical literature looks like the two most likely things a click in the throat would be the superior cornu of the thyroid cartilage rubbing against your tranverse process, thesuperior cornu of the thyroid cartilage rubbing against the hyoid, or the hyoid greater cornua rubbing against the transverse process. You say yours comes from swallowing? Read the above post from the doctor I posted earlier in this forum it really addresses the click in the throat issue your tonsils probably had nothing to do with it at all, I talked to a hyoid click patient who had both tonsils, and his styloid process taken out before they could figure out it was his hyoid bone causing the clicking.

by esssf, Dec 02, 2009 09:20AM
To: wildblue98.... And All
Thanks for replying wildblue98.

Is this something life threatening and what do you think would have to be done for this to go away?

Much appreciated for replying thnaks

Essa.

by silvercat1, Dec 02, 2009 09:49AM
To: esssf
Essa

The notes wildblue are good and informative. I came across an abstract of a medical paper, as follows:

"Corniculate cartilage subluxation is a pathology that has not been reported in the medical literature. Causing vague pharyngeal symptoms, this disease entity may be overlooked or misdiagnosed as chronic nonspecific pharyngitis, globus pharyngis, or laryngopharyngeal reflux disease. A careful laryngoscopic examination is the key to detect this disorder. In this article, we present a 45-year-old patient with the complaints of foreign-body sensation in the throat, difficulty in swallowing solid food, and an urge to turn his head toward the left during the act of swallowing. His laryngeal examination revealed corniculate cartilage subluxation, and excision of the subluxated cartilage was performed by microlaryngoscopic surgery. The patient was free of his symptoms immediately after the operation and remained as such in the 6 months of follow-up. (Am J Otolaryngol 2003;24:118-120."

I think that one of the processes decribed by wildblu is the same thing as described in the above abstract, though I'm not sure, Wildblu could confirm this "corniculate cartilage subluxation" as the same as what wildblu describes?  I don't actually know what subluxation is, I haven't found a definition.

From what I have read so far, the clicking swallow is not life threatening, just in the same way that many bones in the body create clicks and noises such as in the knuckles, or knees, its not life threatening, so try not to worry. I know you're looking for reassurance and being young, you probably feel vulnerable and genuinely need to be reassurred to help settle you so you can concentrate on daily life.

I note that you do jym 5 days/week. Just a thought but it may be that your physical routines have caused some movements of the structures in your throat. But there are some voice coaches who suggests exercises for physical causes of globus pharyngeus, so physical activity may be a good thing. But, I suppose it needs to be in moderation.  If you message me, I can send you a file that I saved from a UK NHS web site on exercises for globus pharyngeus. You haven't got globus, but it could be of interest to see the sorts of things they suggest doing, one of which was to yawn, so that can't be harmful. It may be that such execrcises might? help moving the structrures that cause clicking (wildblu and I in agreement on the cartilages causing the clicks) such that they do not impact? Wildblu might be able to say whether that is a possibility simply from exercise?

When you go to see the ENT, consider asking about whether they can refer you to a voice speech therapist who might be able to help. I am considering this myself. I'm also asking my doc for CT and/or MRI scans to look at the cartilages in the larynx - whether I can persuade him, I'll have to see.  Wildblu has a good paper which describes some causes of clicking throat together with some CT scans that show one cause of the click.

When reading these papers, it's importnat to differentiate click when swallow and click when just moving the neck.  I sometimes get a click when turning my head, looking around and back again. It's not bothersome but my click swallow is bothersome but not painful.


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