Hidden in Plain Sight: Triticeal Cartilage Calcification Causing Odynophagia

Area of Science:

• Anatomy
• Pathology
• Surgical Case Report

Background:

• The triticeal cartilage is a small anatomical structure within the thyrohyoid membrane, present in 33%-53% of individuals.
• Calcification or ossification of the triticeal cartilage is rare but can manifest as dysphagia, odynophagia, or globus sensation.
• Symptomatic triticeal cartilage calcification is poorly understood, lacking established diagnostic and management guidelines.

Purpose of the Study:

• To present a case of symptomatic triticeal cartilage calcification.
• To highlight the diagnostic challenges and successful surgical management of this rare condition.
• To emphasize the importance of considering calcified triticeal cartilage in the differential diagnosis of persistent throat symptoms.

Main Methods:

• A case report of a 44-year-old woman with chronic throat and neck pain and globus sensation.
• Diagnostic workup included physical examination, flexible laryngoscopy, and contrast-enhanced computed tomography (CT) of the neck.
• Surgical exploration and excision of the identified calcified structure.

Main Results:

• CT revealed a submucosal calcification at the thyrohyoid membrane, initially suspected as a foreign body.
• Surgical exploration identified a calcified cartilaginous structure embedded within the pharyngeal constrictors.
• Pathology confirmed fibrous tissue and cartilage; the patient experienced immediate and complete symptom resolution post-excision.

Conclusions:

• Calcified triticeal cartilage is a rare but significant cause of persistent, atypical throat symptoms.
• Recognition and surgical intervention can lead to definitive treatment and symptom resolution.
• This case underscores the need to consider triticeal cartilage calcification in patients with unexplained neck and throat discomfort.