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Avatar universal

Click when swallowing

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
183 Responses
652360 tn?1264492519
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.

1 Comments
My ENT thinks I may have a bone spur that is doing basically the same thing.  Being hit by the thyroid cartilage on swallow.  

This info from Dr. Wolfe is excellent. It may be the answer to this mytserious problem.
Avatar universal
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.
Avatar universal
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
Avatar universal
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.








Avatar universal
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.
Avatar universal
The question above is to anyone that knows anything please get back to me Thanks.
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