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Ischaemic stroke is attributable to thromboembolism caused by carotid atherosclerotic disease in 18-25% of patients. Guidelines for prevention of stroke (especially carotid endarterectomy) in patients with carotid atherosclerotic plaque are based on the quantification of the degree of stenosis.
The hyoid bone, in proximity to the carotid artery, has been implicated in the pathophysiology of carotid artery dissection, atherosclerotic carotid disease, and compressive syndromes. In atherosclerotic carotid disease, pressure on the carotid artery induced by these bone structures has been proposed to play a possible role in plaque formation and rupture, leading to stenosis, occlusion, or artery-to-artery embolism. In a recent ultrasound study, dynamic displacement of the carotid artery with interference of the hyoid bone during swallowing, named as "flip-flop" phenomenon (FFP) has been associated with carotid artery stenosis and stenosis-related stroke. Another study based on CTA assessment observed no association between hyoid-carotid distance and plaque thickness, stenosis, or progression of thickness/stenosis. In that study, in almost two-third of the patients CTA was performed for stroke/transient ischemic attack work-up, including a vast majority of patients with absence of carotid stenosis (median degree of carotid stenosis was 7%), and plaque-related stroke was not assessed.
The objective of this study is to determine the anatomic hyoid-carotid interaction (ie, hyoid-carotid distance, carotid position relative to the hyoid bone, and hyoid morphology) based on CTA and its relation to the degree of carotid stenosis and stenosis-related stroke.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| stenotic carotid | patients with a stenotic carotid |
| |
| non stenotic carotid | patients with non stenotic carotid |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| None, pure observational study | Other | None, pure observational study |
|
| Measure | Description | Time Frame |
|---|---|---|
| Distance hyoid-carotid artery | the closest distance between the hyoid bone and the outer vessel wall of the carotid artery(mm) | Base line, Day 0 |
| Carotid artery portion closest to the hyoid bone | Depending on the level of the carotid bifurcation: common carotid artery [CCA], carotid bifurcation [CB], or internal carotid artery [ICA]) | Base line, Day 0 |
| Carotid artery position in regard to ipsilateral greater horn of the hyoid | The position of the carotid artery in regard to the ipsilateral greater horn of the hyoid (expressed in angle degree, with 0 to 90° corresponding to the posterolateral carotid position, 90 to 180° to anterolateral, 0 to -90° to posteromedial position, and -90 to-180° to anteromedial carotid position) | Base line, Day 0 |
| Hyoid bone morphology | Hyoid width (HW), hyoid length (HL), and hyoid circumferential length (HCL) | base line, day 0 |
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Retrospective analysis of preoperative CTA of 206 consecutive adult patients (>18 years of age) who underwent carotid endarterectomy for symptomatic or asymptomatic stenosis, registered in the stroke database between November 2016 and March 2020 in Nîmes University Hospital (France).
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| Name | Affiliation | Role |
|---|---|---|
| Anissa MEGZARI | Centre Hospitalier Universitaire de Nīmes | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CHU de Nîmes | Nîmes | 30029 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 39571666 | Result | Salaun-Penquer E, Laurent-Chabalier S, Trandafir C, Cosma C, Parvu T, Wacongne A, Thouvenot E, Renard D. Relationship between hyoid-carotid distance, hyoid position and morphology and degree of stenosis and associated stroke: Hyoid-carotid relationship. J Stroke Cerebrovasc Dis. 2025 Jan;34(1):108106. doi: 10.1016/j.jstrokecerebrovasdis.2024.108106. Epub 2024 Nov 19. |
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| ID | Term |
|---|---|
| D016893 | Carotid Stenosis |
| D020521 | Stroke |
| D058225 | Plaque, Amyloid |
| ID | Term |
|---|---|
| D002340 | Carotid Artery Diseases |
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
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| D009422 | Nervous System Diseases |
| D001157 | Arterial Occlusive Diseases |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D020763 | Pathological Conditions, Anatomical |
| D013568 | Pathological Conditions, Signs and Symptoms |