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Surgical and Radiologic Anatomy

, Volume 39, Issue 3, pp 299–306 | Cite as

Clinically relevant variations of the superior thyroid cornu

  • Thomas Shiozawa
  • P. Epe
  • S. Herlan
  • M. Müller
  • A. Tropitzsch
  • I. Tsiflikas
  • B. Hirt
Original Article

Abstract

Purpose

The superior thyroid cornu (STC) of the thyroid cartilage is a variable structure that maybe associated with different clinical symptoms. This study evaluates the three-dimensional anatomy of the STC.

Methods

Measurements were conducted on 97 CT scans (45 male and 52 female). The protocol models a vector from the base to the tip of the STC and references the cornu to the midline. From these data, the length (C), the rotation angle (γ), the inclination angle (β), and the deviation of STC base (X 2) and tip (X 3) from the midline were measured. An additional measure of the medial inclination quotient (Q = X 3/X 2) was calculated.

Results

The STC has a mean length of 13.9 ± 3.26 mm. The male STC is more bent inwards (rotation angle (γ) 60.95° vs. 12.15°; p < 0.001), and the female STC is more steep (inclination angle (β) 75.44° vs. 73.44°; p < 0.001). The mean Q in men was significantly lower (0.85 ± 0.15 vs. 0.97 ± 0.15; p < 0.001). An extreme medial deformation was found in 13.4 % of the patients. This variation is associated with Q ≤ 0.7, most of the time unilateral and more common in men (86.7 vs. 13.3 %). Furthermore, we can describe STC variations with close proximity to the common carotid artery or the cervical spine.

Conclusions

The clinically most relevant variation of the STC seems to be the extreme medial deviation, which may lead to symptoms described with the superior thyroid cornu syndrome. The evaluation of Q in axial CT scans is easily done and may propose a helpful tool for clinical diagnostics.

Keywords

Superior thyroid cornu Superior thyroid cornu syndrome Dysphagia Anatomical variations 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Altman KW, Yu GP, Schaefer SD (2010) Consequence of dysphagia in the hospitalized patient: impact on prognosis and hospital resources. Arch Otolaryngol Head Neck Surg 136:784–789CrossRefPubMedGoogle Scholar
  2. 2.
    Avrahami E, Harel M, Englender M (1994) CT evaluation of displaced superior cornu of ossified thyroid cartilage. Clin Radiol 49:683–685CrossRefPubMedGoogle Scholar
  3. 3.
    Bloem BR, Lagaay AM, van Beek W, Haan J, Roos RA, Wintzen AR (1990) Prevalence of subjective dysphagia in community residents aged over 87. BMJ 300:721–722CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Browning ST, Whittet HB (2000) A new and clinically symptomatic variant of thyroid cartilage anatomy. Clin Anat 13:294–297. doi: 10.1002/1098-2353(2000)13:4<294:AID-CA10>3.0.CO;2-C CrossRefPubMedGoogle Scholar
  5. 5.
    Browning ST, Whittet HB, Williams A (1999) Failure of insertion of a laryngeal mask airway caused by a variation in the anatomy of the thyroid cartilage. Anaesthesia 54:884–886CrossRefPubMedGoogle Scholar
  6. 6.
    Cook IJ (2008) Diagnostic evaluation of dysphagia. Nat Clin Pract Gastroenterol Hepatol 5:393–403. doi: 10.1038/ncpgasthep1153 CrossRefPubMedGoogle Scholar
  7. 7.
    Counter RT (1980) A superior thyroid cornu anomaly: a report of a case. J Laryngol Otol 94:1087–1088CrossRefPubMedGoogle Scholar
  8. 8.
    Fusco DJ, Asteraki S, Spetzler RF (2012) Eagle’s syndrome: embryology, anatomy, and clinical management. Acta Neurochir (Wien) 154:1119–1126CrossRefGoogle Scholar
  9. 9.
    Hajiioannou JK, Florou V, Kousoulis P (2010) Superior thyroid cornu anatomical variation causing globus pharyngeous and dysphagia. Case Rep Med 2010:142928. doi: 10.1155/2010/142928 PubMedPubMedCentralGoogle Scholar
  10. 10.
    Hirano M, Kurita S, Yukizane K, Hibi S (1989) Asymmetry of the laryngeal framework: a morphologic study of cadaver larynges. Ann Otol Rhinol Laryngol 98:135–140CrossRefPubMedGoogle Scholar
  11. 11.
    Kao CH, Wang HW, Lee JC, Chin SC (2005) Pseudotumor of the hypopharynx-displaced superior cornu of the thyroid cartilage. Otolaryngol Head Neck Surg 132:167–168. doi: 10.1016/j.otohns.2004.03.044 CrossRefPubMedGoogle Scholar
  12. 12.
    Karaman E, Saritzali G, Albayram S, Kara B (2011) An unusual cause of foreign-body sensation in the throat: a displaced superior cornu of the thyroid cartilage. Ear Nose Throat J 90:E22–E24PubMedGoogle Scholar
  13. 13.
    Lin D, Fischbein N, Eisele DW (2005) Odynophagia secondary to variant thyroid cartilage anatomy. Dysphagia 20:232–234. doi: 10.1007/s00455-005-0012-2 CrossRefPubMedGoogle Scholar
  14. 14.
    Lindgren S, Janzon L (1991) Prevalence of swallowing complaints and clinical findings among 50-79-year-old men and women in an urban population. Dysphagia 6:187–192CrossRefPubMedGoogle Scholar
  15. 15.
    Mortensen M, Ivey CM, Iida M, Woo P (2009) Superior thyroid cornu syndrome: an unusual cause of cervical dysphagia. Ann Otol Rhinol Laryngol 118:833–838CrossRefPubMedGoogle Scholar
  16. 16.
    Nadig SK, Uppal S, Back GW, Coatesworth AP, Grace AR (2006) Foreign body sensation in the throat due to displacement of the superior cornu of the thyroid cartilage: two cases and a literature review. J Laryngol Otol 120:608–609. doi: 10.1017/S0022215106001125 CrossRefPubMedGoogle Scholar
  17. 17.
    Smith ME, Berke GS, Gray SD, Dove H, Harnsberger R (2001) Clicking in the throat: cinematic fiction or surgical fact? Arch Otolaryngol Head Neck Surg 127:1129–1131CrossRefPubMedGoogle Scholar
  18. 18.
    Wang XL, Gao JH, Xia QT (2006) Displaced superior cornu of the thyroid cartilage. Chin J Otorhinolaryngol Head Neck Surg 41:469Google Scholar

Copyright information

© Springer-Verlag France 2016

Authors and Affiliations

  • Thomas Shiozawa
    • 1
  • P. Epe
    • 1
  • S. Herlan
    • 1
  • M. Müller
    • 2
  • A. Tropitzsch
    • 2
  • I. Tsiflikas
    • 3
  • B. Hirt
    • 1
  1. 1.Institute of Clinical Anatomy and Cell AnalysisEberhard Karls University TuebingenTübingenGermany
  2. 2.Department of Otolaryngology, Head and Neck SurgeryUniversity Hospital TuebingenTübingenGermany
  3. 3.Department of Diagnostic and Interventional RadiologyUniversity Hospital TuebingenTübingenGermany

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