Anterior cervical pain syndrome: Risk factors, variations in hyolaryngeal anatomy, and treatments.

OBJECTIVE

Anterior cervical pain syndromes (ACPS) are a poorly understood entity associated with lateral neck discomfort when talking, chewing, or yawning, and with occasional excruciating pain and dysphagia. This investigation aims to describe patients with ACPS presenting symptoms and treatments.

STUDY DESIGN

Retrospective chart review of all patients with ACPS presenting to a tertiary care laryngology practice in 1 year.

METHODS

All patients diagnosed with ACPS for 1 year were reviewed. Patient gender, age, body mass index (BMI), and pain triggers were documented. The hyolaryngeal complex was measured on computed tomography (CT) scans of the neck. Treatments were recorded.

RESULTS

Nine patients were diagnosed with an ACPS in a 1-year period. Sixty-seven percent were female with an average age of 47.3 years ± 16.6. The average BMI of a patient with ACPS was 24.8 ± 3.69. The most common symptom was point tenderness at the lateral aspect of the hyoid or superior cornu of the thyroid cartilage (89%). Pain triggers included speaking (67%), head turn (56%), chewing (44%), yawning (56%), and swallowing (56%). On CT imaging, eight of nine patients had abnormalities of the hyoid bone or the superior cornu of the thyroid cartilage, correlating 100% with point tenderness location. Treatments include physical therapy (33%), steroid injection (44%), lidocaine injection (22%), and surgical intervention (56%).

CONCLUSION

ACPS is a frustrating condition for patients and physicians. Evaluation of anterior cervical pain with point tenderness should include imaging measurement of the thyrohyoid complex. Effective treatments include local steroid injection and surgical resection of the abnormal structure.

LEVEL OF EVIDENCE

4 Laryngoscope, 130:702-705, 2020.