Asymmetric Near-Complete Ossification of Reichert's Cartilage

This report describes a rare case of asymmetric bilateral ossification of Reichert's cartilage (RC), identified incidentally in a male patient. During a retrospective imaging study of a Greek population, the computed tomography angiography (CTA) of a 43-year-old man was selected due to its unusual morphology. Near-complete asymmetric ossification of the RC was observed, coexisting with an anisomorphic and asymmetric hyoid bone (HB). The right and left greater horns (GHs) measured 28.21 mm and 27.07 mm, respectively. Only the right lesser horn (LH) was identified, which demonstrated ossification and measured 12.17 mm. The left styloid process (SP) measured 78.6 mm in length and 13.81 mm in maximum width, with an angulation of 69.91°, demonstrating near-complete ossification extending to the upper border of C3. It was closely related to the internal carotid artery (ICA) and external carotid artery, with focal compression of the ICA at the superior margin of C2. The right SP measured 53.7 mm in length and 6.54 mm in width, with an angulation of 56.26°. Distal ossification of the RC was also present, arising 14.1 mm from the HB. Additionally, the linguofacial trunk was identified. Recognition of such morphological variants of the RC and HB may improve clinical assessment and surgical planning in the cervical region. Three-dimensional volume-rendered images and multiplanar reconstructions are strongly recommended for accurate anatomical evaluation.