Hidden in Plain Sight: Triticeal Cartilage Calcification Causing Odynophagia

The triticeal cartilage is a small cartilage found within the thyrohyoid membrane present in approximately 33%-53% of individuals. Rarely, calcification/ossification of this cartilage can occur, leading to symptoms of dysphagia, odynophagia, or globus sensation. Despite its clinical relevance, symptomatic triticeal cartilage calcification remains poorly characterized in the literature, with only isolated case reports and no established diagnostic or management framework. We present a case of a 44-year-old woman who presented with seven months of atypical throat and neck pain and globus sensation in the setting of prior esophagogastroduodenoscopy with dilation. Medical management, including nortriptyline and hyoscyamine provided no benefit. Physical examination and flexible laryngoscopy were unremarkable, except for focal left-sided neck tenderness. Contrast-enhanced computed tomography of the neck demonstrated a nonspecific 0.3 x 0.3 x 1.0 cm submucosal calcification at the thyrohyoid membrane, suspicious for retained foreign body. The patient underwent left neck exploration which revealed a calcified cartilaginous structure embedded within the pharyngeal constrictors and immediately adjacent to a pharyngeal plexus branch. Final pathology confirmed fibrous tissue and cartilage. The patient reported immediate, complete symptom resolution and remained symptom-free at 13-month follow-up. This case highlights calcified triticeal cartilage as a rare, often overlooked cause of persistent throat symptoms. Recognition of this pathology may prevent misdiagnosis and allow for timely, definitive treatment.