Fischer Jakob L, Montgomery Emily A, Orestes Michael I
Otolaryngology, Walter Reed National Military Medical Center, Bethesda, USA.
Surgery, Uniformed Services University of the Health Sciences, Bethesda, USA.
Cureus. 2023 Jun 10;15(6):e40219. doi: 10.7759/cureus.40219. eCollection 2023 Jun.
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.
目的 本研究旨在通过描述患者特征、治疗干预措施及治疗反应，对颈前疼痛综合征（ACPSs）患者进行评估。研究设计 这是一项回顾性观察研究。方法 通过回顾一家三级医疗中心的一个喉科诊所七年间与ACPSs相关诊断的治疗患者，经临床和手术记录进行识别和评估。纳入经药物治疗、局部麻醉药与类固醇混合的触发点注射和/或舌骨大角及甲状软骨上角手术切除治疗ACPSs的患者。参与者随后接受病历审查和电话访谈以确定治疗反应。结果 27例患者符合纳入标准，包括12例（44.4%）喉上神经痛（SLN）患者、7例（25.9%）甲状软骨上角综合征（STCS）患者和8例（29.6%）舌骨综合征（HBS）/喉部弹响综合征患者。最常见的症状是颈部/咽喉疼痛（27例，100%）、咽部异物感（20例，74.1%）和吞咽困难（20例，74.1%）。共有24例患者（93.3%）接受了布比卡因和地塞米松的痛点注射。其中，12例患者（52.2%）显示完全缓解，6例患者（26.1%）为永久性缓解。7例患者（25.9%）接受了手术干预，6例患者（85.7%）至少有部分改善。结论 ACPSs构成了一些复杂的诊断，在文献中其特征仍不明确。局部麻醉药与类固醇的痛点注射似乎有效，对于反应不完全或症状复发的患者可选择手术治疗。
