Morphometric examination of the styloid process by 3D-CT in patients with Eagle syndrome

Eagle Syndrome (ES), also termed stylohyoid syndrome or styloid syndrome, is a rare condition characterised by a cluster of symptoms related to an elongation of the styloid process (SP) of the temporal bone. These may range from mild pharyngeal foreign body sensation and dysphagia to severe orofacial pain. High clinical suspicion is necessary owing to the unspecific clinical picture and limited diagnostic clues. Until a definitive diagnosis is achieved, these patients may develop symptoms which significantly impact their quality of life. The aim of this article is to report a case of ES in which a considerable length of SP was documented. Diagnosis was made years after the initial complaints and several medical workups by different specialties. Surgical resection of the elongated process by cervical approach was the adopted treatment modality. Patient recovery and follow-up was satisfactory, with remission of the afflicting symptoms.

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Clinicoradiologic Evaluation of Eagle’s Syndrome and its Management

Kathmandu University Medical Journal ◽

10.3126/kumj.v11i4.12527 ◽

2015 ◽

Vol 11 (4) ◽

pp. 305-309 ◽

Cited By ~ 5

Author(s):

M Pokharel ◽

S Karki ◽

I Shrestha ◽

BL Shrestha ◽

K Khanal ◽

...

Keyword(s):

Ct Scan ◽

Styloid Process ◽

History Taking ◽

3D Ct ◽

Ct Reconstruction ◽

Eagle’S Syndrome ◽

Elongated Styloid Process ◽

Intraoral Approach ◽

3D Ct Scan ◽

Significant Difference

Background Eagle’s syndrome (Elongated styloid process) is often misdiagnosed due to its vague symptomatology. The diagnosis relies on detail history taking, palpation of styloid process in tonsillar fossa and imaging modalities.Objective To assess the length and medial angulation of elongated styloid process with the help of three dimensional computed tomography (3D CT) scan and to describe our clinical and surgical experience with patients suffering from Eagle’s syndrome.Method Prospective, analytical study conducted from August 2011 to August 2012 among 39 patients with Eagle’s syndrome. Detailed history taking, clinical examination and 3D CT scan was performed. Length and medial angulation was calculated. Patients with styloid process length longer than 2.50 cm underwent surgical excision via intraoral approach. Medial angulation of styloid process on both sides was correlated with each other using rank correlation coefficient. Wilcoxon Signed Rank test was applied to test significant difference between pre-operative and post-operative symptoms scores.Result Significant positive correlation was found between the medial angulation of styloid process on right side and left side (? =0.81, p<0.001). Significant difference was also observed between pre and post-operative symptoms scores (z=-5.16, p<0.001) .Conclusion Possibility of Eagle’s syndrome should always be considered while examining patients with vague neck pain. 3D CT reconstruction is a gold standard investigation which helps in studying the relation of styloid process with surrounding structures along with accurate measurement of its length and medial angulation.Kathmandu Univ Med J 2013; 11(4): 305-309

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Important factor for pain relief in patients with eagle syndrome: Excision technique of styloid process

American Journal of Otolaryngology ◽

10.1016/j.amjoto.2018.10.009 ◽

2019 ◽

Vol 40 (2) ◽

pp. 337

Author(s):

Fatma Caylakli

Keyword(s):

Pain Relief ◽

Styloid Process ◽

Eagle Syndrome

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Surgical treatment of Eagle’s Syndrome through intraoral access: a case report and literature review

Brazilian Journal of Case Reports ◽

10.52600/2763-583x.bjcr.2021.1.1.15-21 ◽

2021 ◽

Vol 1 (1) ◽

pp. 15-21

Author(s):

Rodrigo Cristhian Avelino Bezerra ◽

Jonas Nogueira Ferreira Maciel Gusmão ◽

Bruno Frota Amora Silva ◽

Rodrigo Lemos Alves ◽

Eliardo Silveira Santos ◽

...

Keyword(s):

Case Report ◽

Surgical Treatment ◽

Literature Review ◽

Facial Pain ◽

Clinical Case ◽

Styloid Process ◽

Eagle’S Syndrome ◽

Intraoral Approach ◽

Eagle Syndrome ◽

Review Study

The styloid process is a bone projection that originates in the tympanic portion of the temporal bone. The enlongation of the styloid process, or the ossification of the styloid process, can originate a series of symptoms such as dysphagia, odynophagia, facial pain, otalgia, headache, tinnitus and trismus, establishing the clinical picture of Eagle Syndrome. In this report, we present an important clinical case of adult patient diagnosed with Eagle’s Syndrome who underwent surgery for reduction of the enlongated styloid process, by intraoral approach, added to a literature review study.

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Eagle syndrome as a rare cause of recurrent transient ischemic stroke in Senegal (West Africa)

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20213294 ◽

2021 ◽

Vol 7 (9) ◽

pp. 1534

Author(s):

Birame Loum ◽

Cheikh Ahmedou Lame ◽

Cheikhna B. Ndiaye ◽

Kamadore Toure ◽

Mouhamadou Mansour Ndiaye

Keyword(s):

Risk Factors ◽

Ischemic Stroke ◽

Carotid Artery ◽

Internal Carotid Artery ◽

Internal Carotid ◽

Rare Condition ◽

Styloid Process ◽

Neurological Impairment ◽

Vascular Events ◽

Eagle Syndrome

<p>Eagle syndrome is a rare condition, often characterized by nonspecific symptoms. It is due to an abnormally long or compressive styloid process on surrounding structures. Exceptionally, it can cause neuro-vascular manifestations. We report an observation of Eagle syndrome discovered incidentally in presence of recurrent transient ischemic stroke. A 74-year-old man with no cardiovascular risk factors, was admitted to our department following 4 episodes of transient ischemic stroke with right hemiplegia and aphasia, always rapidly resolving. Head and neck CT scan showed 2 long styloid processes with a marked impingement of the left one against the ipsilateral internal carotid artery. Intraoral styloidectomy was performed. The patient recovered fully and remained free of symptoms without neurological impairment, at 6 months. Eagle syndrome is a rare condition which may lead, exceptionally, to repetitive transient ischemic stroke. Surgical styloidectomy must be considered to reduce the risk of new vascular events and prevent serious complications such as dissection of the internal carotid artery.</p>

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EVALUATION OF PATIENTS WITH ELONGATED STYLOID PROCESS WITH 3D CT SCAN OF NECK

ORISSA JOURNAL OF OTOLARYNGOLOGY AND HEAD AND NECK SURGERY ◽

10.21176/ojolhns.2017.11.2.7 ◽

2017 ◽

Vol XI (II) ◽

pp. 32-34

Author(s):

Netra Pathak A ◽

◽

Vidya Rokade V ◽

Keyword(s):

Ct Scan ◽

Styloid Process ◽

3D Ct ◽

Elongated Styloid Process ◽

3D Ct Scan

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Measurement of Length of Styloid Process by Orthopantomography

Journal of Gandaki Medical College-Nepal ◽

10.3126/jgmcn.v12i1.22606 ◽

2019 ◽

Vol 12 (1) ◽

pp. 17-21

Author(s):

BR Sharma ◽

S Singh ◽

M Timilsina ◽

P Sharma ◽

K Sharma

Keyword(s):

Average Length ◽

Imaging Modality ◽

Anatomical Variation ◽

College Teaching ◽

Styloid Process ◽

Research Centre ◽

Radiographic Examination ◽

Measurement Tool ◽

Oral Radiology ◽

Eagle Syndrome

Background: Styloid process (SP) is an anatomical structure whose elongation is not well understood. Proper clinical and radiological assessment is needed to detect an elongated SP. Anatomical variation is also common. SP is said to be elongated if longer than 30 mm. Orthopantomogram (OPG) is also an imaging modality by which we can view SP. Objective: The objective of this study was to assess the SP on OPG and identify eagle syndrome. Materials and Methods: The study was conducted on archived OPG radiographs available in the Department of Oral Radiology, Gandaki Medical College Teaching hospital and Research Centre. These radiographs were from patients who were subjected to radiographic examination for other dental problems. The length of SP was measured on both sides using the measurement tool bars on the accompanying analysis software. Results: Average length of SP on males was 26.5 mm ±14.4 mm in right and 25.5 mm ±6.19 mm in left; and on females was 23.78 mm ±5.93 mm on right and 24.7 mm ±10.44 mm in left. Elongated SP was more on males compared to females. Elongated styloid process (ESP) was more prevalent in 21 - 30 years of age group, similarly unilateral and bilateral elongation was also predominant on males compared to females. Conclusion: OPG is also useful for detection of an ESP in patients with or without symptoms and helps to avoid misdiagnosis of tonsillar pain or pain of dental, pharyngeal or muscular origin as well as Eagle syndrome (ES).

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Entrapment of the glossopharyngeal nerve in patients with Eagle syndrome: surgical technique and outcomes in a series of 5 patients

Journal of Neurosurgery ◽

10.3171/2009.1.jns08485 ◽

2009 ◽

Vol 111 (6) ◽

pp. 1226-1230 ◽

Cited By ~ 21

Author(s):

John H. Shin ◽

Sebastian R. Herrera ◽

Paula Eboli ◽

Sabri Aydin ◽

Emad H. Eskandar ◽

...

Keyword(s):

Pain Relief ◽

Medical Center ◽

Pain Syndrome ◽

Styloid Process ◽

Glossopharyngeal Nerve ◽

Surgical Morbidity ◽

Elongated Styloid Process ◽

Operative Indications ◽

Eagle Syndrome ◽

The Many

Object Eagle syndrome is characterized by unilateral pain in the oropharynx, face, and earlobe, and is caused by an elongated styloid process or ossification of the stylohyoid ligament with associated compression of the glossopharyngeal nerve. The pain syndrome may be successfully treated with surgical intervention that involves resection of the styloid process. Although nerve decompression is routinely considered a neurosurgical intervention, Eagle syndrome and its treatment are not sufficiently examined in the neurosurgical literature. Methods A review was performed of cases of Eagle syndrome treated in the Department of Neurosurgery at the University of Illinois at Chicago Medical Center over the last 7 years. The clinical characteristics, radiographic imaging, operative indications, procedural details, surgical morbidity, and clinical outcomes were collected and analyzed. Results Of the many patients with facial pain treated between 2001 and 2007, 7 were diagnosed with Eagle syndrome, and 5 of these patients underwent resection of the elongated styloid process. There were 4 women and 1 man, ranging in age from 20 to 68 years (mean 43 years). The average duration of disease was 11 years. In all patients, a preoperative workup revealed unilateral or bilateral elongation of the styloid process. All patients underwent resection of the styloid process on the symptomatic side using a lateral transcutaneous approach. There were no surgical complications. All patients experienced pain relief immediately after the operation. At the latest follow-up (average 46 months, range 7 months to 7.5 years) all but 1 patient maintained complete pain relief. In 1 patient, the pain recurred 12 months postoperatively and additional interventions were required. Conclusions Eagle syndrome may be considered an entrapment syndrome of the glossopharyngeal nerve. It is a distinct clinical entity that should be considered when evaluating patients referred for glossopharyngeal neuralgia. The authors' experience indicates that patients with Eagle syndrome may be successfully treated using open resection of the elongated styloid process, which appears to be both safe and effective in terms of long-lasting pain relief.

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