The Case of Stylohyoid Calcification with Clarification

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Almost every day I point out to a patient that they have a calcified stylohyoid ligament going from behind their ear to the hyoid bone in their neck. Check out this xray:

In my practice I see such a bony formation every day of the week. Maybe this is because my practice sees so many patients who have neck, back, and head pain. Maybe this anomaly is becoming more and more frequent in people. Who knows?

Let me explain. There is a ligament (which is soft tissue and will NOT show on an xray generally) that goes from the styloid process behind your ear to the hyoid bone in your neck. It will not show on an xray unless it has calcified into bone. It generally calcifies when the neck is damaged or out of alignment and needs more support. Think of it like this: Your body recognizes that your neck is not stable so it is trying to form ‘struts’ or supports to stabilize the neck. When this calcification process takes place, many people can feel it in the form of difficulty with swallowing pills or vitamins, and even swallowing many foods can be difficult. If you look up ‘Eagle’s Syndrome’ this is what we are talking about in many cases. This calcification makes it more difficult to swallow food and pills and can be quite annoying.

So what do you do about it? Mostly, nothing. In the very old days, my mentor, Dr. Brendan Stack, might have his ENT surgeon cut the bones away, but that was really painful and the patient had to take off a lot of time from work. It was quite cumbersome. These days we mostly recommend that you do physical therapy to get the neck into better alignment with the hope that the bone is no longer necessary, and it just might dissolve away over time. As long as you can manage this quirky little bony formation, I believe that is the best approach rather than an invasive surgery. This is one of the strong reasons that I have our patients see the PT –physical therapist- to keep the neck aligned as best as possible.

Since this annoying little bone keeps showing up in my xray studies- every day it seems- I thought it would be prudent to show everyone how prominent it really is and that in most cases being aware of it and doing PT is good enough- for now.