Eagle Syndrome: an underdiagnosed cause of orofacial pain

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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Eagle’s Syndrome as a Cause of Discomfort and the Subjective Presence of a Foreign Body in the Throat

Diagnostics ◽

10.3390/diagnostics11101832 ◽

2021 ◽

Vol 11 (10) ◽

pp. 1832

Author(s):

Irena Wolińska ◽

Przemysław Jaźwiec ◽

Maria Pawłowska ◽

Paweł Gać ◽

Rafał Poręba ◽

...

Keyword(s):

Foreign Body ◽

Carotid Arteries ◽

Rare Condition ◽

Styloid Process ◽

Foreign Body Sensation ◽

Eagle’S Syndrome ◽

Elongated Styloid Process ◽

Body Sensation ◽

Eagle Syndrome ◽

Craniofacial Pain

Eagle syndrome consists of symptoms resulting from the elongation and excessive calcification of the styloid process of the temporal bone and calcification of the ligaments associated with this process. The main symptoms of this syndrome are the feeling of a foreign body in the throat, dysphagia and pain localized in the temporomandibular region, neck and ear. The authors describe the case report of a previously healthy 39-year-old Caucasian male that complained of discomfort and foreign body sensation in his throat. Computed tomography (CT) showed the presence of an elongated styloid process bilaterally with clear predomination at the left side. The patient underwent laryngological and surgical consultation. Due to the lack of symptoms related to the compression of the carotid arteries, no surgery was recommended. In summary, Eagle’s syndrome is a rare condition characterized by craniofacial pain or foreign body sensation that should be considered, especially if the pain is unilateral. CT imaging in his case was a perfect tool and enabled a suitable diagnosis of this rare syndrome.

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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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Relato de caso: Dissecção Carotídea associada a Síndrome de Eagle

10.5327/1516-3180.235 ◽

2021 ◽

Author(s):

Vinícius de Queiroz Aguiar ◽

Gustavo Sales França ◽

Bernardo Costa Berriel Abreu ◽

Talles Henrique Caixeta ◽

Alexandre Henrique de Azevedo Dias ◽

...

Keyword(s):

Carotid Artery ◽

Internal Carotid Artery ◽

Internal Carotid ◽

Clinical Manifestations ◽

Styloid Process ◽

Left Internal Carotid Artery ◽

Partial Recovery ◽

Body Sensation ◽

Eagle Syndrome ◽

Vessel Dissection

Context: Eagle syndrome is characterized by the elongation or disfiguration of the styloid process, which leads to a range of clinical manifestations resulting from the structures that are affected by the prolongation of the bone, and the classic presentation is composed of pain and foreign body sensation in the throat, otalgia, and dysphagia. Case report: We describe the case of a 60-year-old man with an ischemic stroke due to dissection of the left internal carotid artery, associated with compression resulting from Eagle syndrome. At clinical presentation, the patient presented right hemiparesis and severe dysphagia, with NIH=18, characterizing the stroke. An angiotomography of the skull and brain was performed, which showed an image compatible with dissection of the left internal carotid artery from the prolongation of the styloid process, characterizing Eagle syndrome stylocarotid syndrome. The patient was submitted to thrombolysis with rt-PA, presenting a partial response, and surgical bone reduction. Patient evolved with partial recovery, with NIH=10, and, at the time of discharge, presented RANKIN 1, symptoms without disabilities. Conclusion: The Eagle syndrome, while it occurs more frequently in women, in general, with the classic presentation, can evolve with a more severe picture, associated with vessel dissection and brain involvement.

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Eagle’s Syndrome: Transoral Styloidectomy a Technique Modification Case Report

Journal of Oral & Dental Health ◽

10.33140/jodh.04.03.02 ◽

2020 ◽

Vol 4 (3) ◽

Keyword(s):

Correct Diagnosis ◽

Rare Condition ◽

Signs And Symptoms ◽

Styloid Process ◽

Unknown Etiology ◽

Eagle’S Syndrome ◽

Anatomical Structures ◽

History Of ◽

Eagle Syndrome ◽

Sixth Decade

Eagle’s Syndrome is a rare condition with unknown etiology that mainly affects female patients between the third and sixth decade of life. It was first described in 1937 by Dr. Watt W. Eagle, in a study carried out in a group of patients whose main symptom was cervicopharyngeal pain caused by elongation of the styloid process and/or calcification of the stylohyoid ligament [1]. The diagnosis of this pathology is based on the anamnesis and physical examination together with imaging exams of the patients. Cervicofacial pain, palpation of the styloid process in the tonsillar fossa and limitation in neck mobility are the most classic signs and symptoms of this disease [2]. Due to the nonspecific symptoms present in these patients, this disease is usually underdiagnosed and confused with temporomandibular disorders, cervical myalgias, and even being diagnosed as atypical trigeminal neuralgias [3]. For this reason, clinical examination and imaging exams, are indispensable for the correct diagnosis and evaluation of anatomical structures [3]. We present a case of a woman with a history of eagle syndrome which was diagnosed and treated at the Hospital clinico metropolitano El Carmen Santiago, Chile.

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An Asymptomatic and Overelongated Styloid Process

Case Reports in Dentistry ◽

10.1155/2017/7971595 ◽

2017 ◽

Vol 2017 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Emrah Soylu ◽

Ahmet Altan ◽

Ahmet Ercan Sekerci ◽

Nıhat Akbulut

Keyword(s):

Clinical Symptoms ◽

Present Report ◽

Rare Condition ◽

Styloid Process ◽

Anatomical Structures ◽

Elongated Styloid Process ◽

Eagle Syndrome

Elongation of the styloid process is a rare condition. Only 4% of patients have clinical symptoms where elongated styloid process (ESP) occasionally irritates or disrupts adjacent anatomical structures, which is called Eagle syndrome. This present report was aimed at reporting an asymptomatic ESP with unusual width and length.

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Eagle’s syndrome - a report of two cases

Vojnosanitetski pregled ◽

10.2298/vsp1505458k ◽

2015 ◽

Vol 72 (5) ◽

pp. 458-462 ◽

Cited By ~ 2

Author(s):

Aleksandar Kiralj ◽

Miroslav Ilic ◽

Bojan Pejakovic ◽

Borislav Markov ◽

Sasa Mijatov ◽

...

Keyword(s):

Surgical Techniques ◽

Styloid Process ◽

Surgical Approaches ◽

Advantages And Disadvantages ◽

Postoperative Control ◽

First Case ◽

Intraoral Approach ◽

Body Sensation ◽

Eagle Syndrome ◽

Stylohyoid Ligament

Introduction. Eagle?s syndrome is defined as elongation of the styloid process or the stylohyoid ligament mineralization complex which consist of styloid process, stylohyoid ligament and lesser horn of hyoid bone. It is a rare entity, is not commonly suspected in clinical practice. It is characterized by recurrent facial and throat pain, dysphagia, odynophagia, parapharingeal foreign body sensation, otalgia and neck pain. Eagle?? syndrome can be treated conservatively (lacing local anesthetic into the styloid process and stylomandibular ligament attachment) or surgically. Its pathogenesis and threatment modalities are still being debated while different theories have been presented. Case report. The two traditional surgical approaches to styloidectomy (removal of the elongated portion of the styloid process) were presented the intraoral approach and the extraoral approach. We presented two cases (49 years and 34 years old males), with bilateral and unilateral elongated styloid process. The surgical treatment included unilateral right side stiloidectomy by intraoral approach in the first case and right styloidectomy by extraoral approach in the second case. In both eases post-operative course passed regularly with no complaints at regular postoperative control. Conclusion. Surgical techniques for treatment of Eagle?s syndrome have many advantages and disadvantages. We believe that the length of the styloid process or the calcified ligament is a decisive parameter for the selection of techniques and approach.

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Assessment of surgical treatment of Eagle’s syndrome

Otolaryngologia Polska ◽

10.5604/01.3001.0013.1533 ◽

2019 ◽

Vol 73 (3) ◽

pp. 1-5

Author(s):

Marcin Czajka ◽

Mariusz Szuta ◽

Jan Zapała ◽

Iga Janecka

Keyword(s):

Quality Of Life ◽

Statistical Analysis ◽

Surgical Treatment ◽

Styloid Process ◽

Late Results ◽

Wilcoxon Test ◽

Eagle’S Syndrome ◽

Improvement Rate ◽

Eagle Syndrome

Introduction: The aim of the study was to assess the effectiveness of surgical treatment of patients with Eagle's syndrome, taking into account both early and late results. Materials and methods: The study group consisted of 15 patients who underwent resection of the styloid process due to Eagle syndrome in the period of 2005-2017. During the follow-up visit, the patients were asked to fill in a post-operative questionnaire that compared the pre-operative symptoms and their severity with the patients' current health condition. The VAS pain scale was used to assess each symptom, and the Laitinen scale was used to assess the quality of life. Data from patients' medical records were also included. The results of the surveys were subjected to statistical analysis. Results: The study showed that in 11 out of 15 cases there was a significant improvement in the level of pain (70.5% on average) and an improvement in quality of life (on average 65%) comparing to the pre-operative condition. The Wilcoxon test for binding pairs, the Mann-Whitney test, the Kruskal-Wallis test and the Spearman correlation coefficient were used in the statistical analysis. There were statistically significant correlations between the recorded improvement rate and the length of the resected styloid process and its setting. Discussion: The study proved that resection of prolonged styloid process from extraoral approach in most cases is an effective method of treatment of Eagle syndrome, that carries low risk of complications.

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Eagle’s Syndrome Presenting As Unilateral Pain In The Anterolateral Neck And Referred Otalgia

Journal of Bahria University Medical and Dental College ◽

10.51985/jbumdc2018104 ◽

2018 ◽

Vol 09 (01) ◽

pp. 77-79

Author(s):

Waseem Mehmood Nizamani ◽

Ameet Jesrani ◽

Mujtaba Khan ◽

Kalthoum Tlili ◽

Nader Al Khuraish ◽

...

Keyword(s):

Multislice Computed Tomography ◽

Rare Condition ◽

Styloid Process ◽

Maximum Intensity ◽

Eagle’S Syndrome ◽

Anatomical Structures ◽

Body Sensation ◽

Wide Range ◽

Stylohyoid Ligament ◽

Maximum Intensity Projections

Eagles syndrome or stylohyoid syndrome is a rare condition where slender elongated temporal styloid process or ossified stylohyoid ligament manifest a wide range of symptoms including otalgia, dysphagia, foreign body sensation in throat, pain in retrogonia or along anterolateral neck. It occurs mostly unilaterally however bilateral cases are also reported. Multislice computed tomography with maximum intensity projections reconstructions is used for diagnosis and management purposes. It also aids to see its compressive effect on adjacent anatomical structures

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Riga-Fede disease: a mimicker of malignancy

BMJ Case Reports ◽

10.1136/bcr-2020-235976 ◽

2021 ◽

Vol 14 (3) ◽

pp. e235976

Author(s):

Somu Lakshmanan ◽

Srinivasan Venkataraman ◽

Urvashi Singh

Keyword(s):

Histopathological Examination ◽

Eosinophilic Granuloma ◽

Rare Condition ◽

Malignant Tumour ◽

Clinical Suspicion ◽

Inflammatory Condition ◽

Unique Case ◽

Body Sensation ◽

History Of

Riga-Fede disease (RFD), also known as traumatic eosinophilic granuloma, is a benign inflammatory condition of the oral cavity that may mimic a malignant tumour. It’s a rare condition mainly reported in infants. We present a unique case report of a 57-year-old man who presented to our outpatient department with foreign body sensation in the throat and swelling over the dorsum of the tongue for a period of 1 month. He gave no history of trauma, especially due to sharp teeth. Video laryngoscopy done revealed an ulceroproliferative growth on the midline of the dorsum of the tongue. With clinical suspicion of malignancy, the patient underwent wide local excision of the tongue lesion. Histopathological examination was suggestive of RFD. The postoperative follow-up was uneventful with good wound healing. The patient was followed up with no evidence of recurrence.

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Eagle Syndrome: An Unusual Cause of Stroke Successfully Treated by Angioplasty and Mechanical Thrombectomy

Neurology and Neurobiology ◽

10.31487/j.nnb.2020.02.09 ◽

2020 ◽

pp. 1-4

Author(s):

Elisa Ciceri ◽

Marco Conte ◽

Mauro Plebani ◽

Piergiuseppe Zampieri ◽

...

Keyword(s):

Blood Flow ◽

Mechanical Thrombectomy ◽

Styloid Process ◽

Neurological Status ◽

Left Internal Carotid Artery ◽

Eagle Syndrome ◽

Cerebral Ischemic Stroke ◽

Cerebral Ischemic ◽

Multiphase Ct

We report a case of a 50-year-old male presenting with right arm weakness and mixed aphasia after motorcycle accident. Basal CT/MR imaging showed absence of acute brain lesions and left internal carotid artery (ICA) wall hematoma at C1-C2 level close to a prominent styloid process. Multiphase CT angiography confirmed ICA dissection and a hypertrophic styloid process compressing the ICA at the same level; ipsilateral intracranial blood flow delay and good collateral circulation were present in the latest CTA phases [1]. Due to Patient neurological status deterioration, with progressive global aphasia and right hemiplegia onset, digital subtraction angiography (DSA) was performed urgently. DSA confirmed the CTA findings together with slowing of cerebral blood flow above the dissection; after mechanical thrombectomy by aspiration followed by balloon angioplasty, good blood flow and vessel caliber restoration were obtained. Post-procedural control and follow-up findings are described together with revision of the recent literature on the possible association between cerebral ischemic stroke and Eagle syndrome.

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