Thyroid Foramen: Prevalence and CT Morphology.
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RATIONALE AND OBJECTIVES: The thyroid foramen (TF) is a congenital anatomical variant of the thyroid cartilage, characterized by a small opening that may transmit neurovascular structures. Although benign, TF can be misinterpreted on imaging as a cartilage fracture or tumor invasion, and may pose a surgical risk if unrecognized. Despite these potential implications, TF remains under-recognized in routine radiological practice. This study aimed to evaluate the prevalence and morphological characteristics of TF using CT. MATERIALS AND METHODS: We retrospectively reviewed 300 noncontrast, thin-slice neck CT scans. TF was defined as a well-demarcated, smoothly marginated opening in the posterior thyroid cartilage. Two experienced radiologists evaluated all images in consensus, documenting the presence, shape, laterality, and size of TF. RESULTS: TF was identified in 77 of 300 patients (25.7%). The prevalence was slightly higher in males (27.8%) than in females (22.6%), but the difference was not statistically significant (p=.348). Among TF-positive cases, 24 had bilateral and 53 had unilateral TFs, totaling 101 foramina. Of these, 48.5% were circular, 41.6% oval, and 9.9% crescent-shaped. The mean long and short axes were 3.1±1.1 mm and 2.6±1.0 mm, respectively. TF diameters were significantly larger in males (p<.001 and p=.003 for long- and short-axis), but showed no correlation with age (p=.338 and .742, respectively). CONCLUSION: TF is a relatively common anatomical variant detectable on thin-slice CT, with a prevalence of 25.7%. Awareness of TF is important to avoid diagnostic pitfalls and prevent potential surgical complications.