'The sore throat that is not a sore throat' - What is Carotidynia?
Frequently our patients describe sore throats as part of their recurring symptom complex. Often, when specifically asked, the patients note that ear pain accompanies the throat pain, but the patients often state that their primary physician can find no reason for their discomfort. In fact, on examination, there is no sign of inflammation of the throat or ear.
The condition 'carotidynia' is little known but is, in fact, common. On careful examination, one can easily detect swelling and pain at the carotid bulb, which is located just lateral to the top of the thyroid cartilage (Adam's Apple) and is the location at which the internal and external carotid arteries separate, or bifurcate.
Our theory is that this is yet another sign of inflammatory neurological disease associated with LBC, since the carotid bulb is known to be a baroreceptor, which means it plays a prominent role in monitoring blood pressure. As such, it is loaded with nerve fibers, some of which mediate pain. Since the fibers at the bulb lie in proximity to the throat and may radiate to the ear area, our patients complain of 'sore throat and earache', when in fact the throat and ear pain arise from an inflamed carotid bulb. The mediation of this pain is most likely from the Nerve of Hering, a branch of the 9th cranial nerve (glossopharyngeal nerve), and/or a branch of the superior cervical sympathetic chain.