Relationship between hyoid-carotid distance, hyoid position and morphology and degree of stenosis and associated stroke.

Background: Pressure on carotid artery by hyoid bone may influence plaque formation. We studied CTA-based hyoid-carotid anatomical interaction and its relationship with carotid stenosis degree and stenosis-related stroke.

Methods: We retrospectively analysed pre-operative CTA of 205 consecutive adults having undergone carotid endarterectomy (CEA) for asymptomatic or symptomatic stenosis. Radiological measurements were: degree stenosis, hyoid-carotid distance, carotid position in regard to hyoid, and hyoid morphology.

Results: In total, 410 carotids (including 114 symptomatic and 296 asymptomatic stenotic and non-stenotic carotids) from 205 CEA patients (median age 74, 72% men) were analysed. Median carotid stenosis was 61% (70% for symptomatic and 51% for asymptomatic carotids, p<0.0001; 70% for CEA and 30.5% for non-CEA carotids, p<0.0001). None of the other radiological parameters differed between asymptomatic/symptomatic carotids, between non-CEA/CEA carotids, or between asymptomatic/symptomatic patients. Median hyoid-carotid distance was 4.3mm, with 82% of carotids in posterolateral quadrant position in regard to the hyoid. There was no correlation between stenosis degree and hyoid-carotid distance (rho=-0.039), hyoid width (rho=-0.079), length (rho=0.007) or circumferential length (rho=-0.005), and stenosis degree was comparable between different carotid position quadrants (p=0.51).

Conclusions: Hyoid-carotid distance, hyoid position and morphology are not correlated with the degree of carotid stenosis or symptomatic carotid stenosis.

Clinical trial registration-url: http://www.

Clinicaltrials: gov: Unique identifier: NCT05349526.