Case Report: Ossification of the ligamenta stylohyoidei after recurrent strangulation trauma in childhood

Introduction There is a variety of dysphagia diseases and with the absence of clinical findings they are often assigned to mental illness.

Method A 41-year-old male patient presented with progressive odynodyspagia and a feeling of tightness with recurrent suffocation anxiety for 6 months. Only a liquid nutrition was possible. He has a history of a long-term child abuse with frequent strangulation. The abuse resulted in a posttraumatic disorder disease (PTSD) type II.

Results In clinical examination a clearly limited laryngeal elevation appeared in FEES as well as a tonsil hyperplasia. The CAT-scan of the neck showed a long-distance ossification of the lig. stylohyoideum on both sides. For therapy we did a median partial resection of the os hyoideum and an enoral resection of the processus styloidei combined with a tonsillotomy on both sides. In the context of postoperative care the patient needed pain service, psychotraumatology and intensive logopaedic exercise therapy. A nutrition with solid food is possible. The PTSD remained.

Conclusion Doctors often deny swallowing disorders. In our case the preliminary findings showed no abnormalities, so the patient relived the negation of his problems as happened before during the child abuse. We assume that the abuse, especially the recurrent strangulation, led to this massive ossification of the ligg. stylohyoidei. Several cases have been reported. It is crucial that we use dynamic diagnostics (FEES, videofluoroscopy) in order to identify and evaluate dysphagia.

Poster-PDF A-1811.PDF

Publication History

Article published online:
10 June 2020