Anterior Cervical Pain Syndromes: Defining the Patient Population and Approach to Treatments

Jakob L Fischer; Emily A Montgomery; Michael I Orestes

doi:10.7759/cureus.40219

Anterior Cervical Pain Syndromes: Defining the Patient Population and Approach to Treatments

Cureus. 2023 Jun 10;15(6):e40219. doi: 10.7759/cureus.40219. eCollection 2023 Jun.

Authors

Jakob L Fischer¹, Emily A Montgomery², Michael I Orestes^{1

2}

Affiliations

¹ Otolaryngology, Walter Reed National Military Medical Center, Bethesda, USA.
² Surgery, Uniformed Services University of the Health Sciences, Bethesda, USA.

Abstract

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.

Keywords: anterior cervical pain syndrome; clicking larynx; hyoid bone syndrome; laryngology; superior laryngeal neuralgia; superior thyroid cornu syndrome; throat pain.