Bilateral Atypical Facial Pain Caused by Eagle’s Syndrome

Recurrent throat pain, “foreign body” sensation, difficulty in swallowing, or vague facial pain is many times caused by the presence of an elongated styloid process. Many times, this condition is misdiagnosed and the patient is treated for facial neuralgia. But once Eagle’s syndrome is confirmed by clinical and radiological examination, the treatment is always surgical resection. The approach maybe intraoral or extraoral. In this paper, we present a case of Eagle’s syndrome caused by bilateral elongation of the styloid process and where surgical resection of the same gave instant permanent relief for the patient.

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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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Unilateral Eagle’s Syndrome

Journal of Bangladesh College of Physicians and Surgeons ◽

10.3329/jbcps.v40i1.57063 ◽

2022 ◽

Vol 40 (1) ◽

pp. 72-74

Author(s):

Md Talal Mamun ◽

Rahat Amin Chowdhury

Keyword(s):

Facial Pain ◽

Adult Population ◽

Common Factor ◽

Styloid Process ◽

Principal Factor ◽

Transoral Approach ◽

Eagle’S Syndrome ◽

Detailed History ◽

Elongated Styloid Process ◽

Stylohyoid Ligament

Eagle’s syndrome represent as a neck, cervicofacial pain, dysphagia, facial pain, globus sensation, tinnitus, otalgia and headache, it may be unilateral or bilateral. About 4% of adult population accounted elongated styloid process, which are the principal factor of Eagle’s syndrome and followed by 0.16% of patients are symptomatic. Stylohyoid ligament calcification is the second most common factor. The diagnosis must be made through a detailed history, clinical examination, and various imaging modalities. A 36 years old female patient presented with persistent pain in the throat. An elongated styloid process was diagnosed and was removed by transoral approach following the patient was relieved from her symptoms. J Bangladesh Coll Phys Surg 2022; 40: 72-74

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Tonsillostyloidectomy for Eagle’s syndrome: a study of 20 cases

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20160064 ◽

2016 ◽

Vol 2 (1) ◽

pp. 22

Author(s):

Roohie Singh ◽

Jeevan R. Galagali

Keyword(s):

Foreign Body ◽

Clinical Symptoms ◽

Laryngopharyngeal Reflux ◽

Pain Syndrome ◽

Styloid Process ◽

Eagle’S Syndrome ◽

Throat Pain ◽

Body Sensation ◽

Laryngopharyngeal Reflux Disease ◽

Oral Approach

Background: Eagle’s syndrome is a pain syndrome which occurs due to elongated and misdirected styloid process. It is commoner than generally thought.Methods: 20 cases of styalgia were diagnosed and prospectively studied at two hospitals. The characteristic symptoms were chronic throat pain and foreign body sensation in throat. Diagnosis was made with clinical symptoms, physical examination in form of intraoral palpation of styloid and radiological correlation. All patients underwent Tonsillostyloidectomy for affected sites under General anaesthesia. The patients were followed up for 12 weeks post-operatively and relief of symptoms was noted. Results: Chronic throat pain was the commonest symptom. Most cases were associated with chronic tonsillitis or Laryngopharyngeal reflux disease (LPRD). 19 (95%) patients were symptom free by 4 weeks postoperatively.Conclusions: In an established case of Styalgia with intraoral palpable styloid tip, tonsillostyloidectomy by intra-oral approach gives good results. Also, LPRD may be a possible aetiology of the disease. Incidentally, it was found that position of head over neck should be intraoperatively adjusted in order to suit easy approach to the styloid depending on antero-posterior angulation of styloid.

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A clinical study of the patients with elongated styloid process

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20171201 ◽

2017 ◽

Vol 3 (2) ◽

pp. 400 ◽

Cited By ~ 2

Author(s):

Suhas Y. Choudhari ◽

Aravind B. Sangavi

Keyword(s):

Serum Calcium ◽

Facial Pain ◽

Styloid Process ◽

X Ray ◽

Throat Pain ◽

Elongated Styloid Process ◽

Body Sensation ◽

A Prospective Study ◽

Hematological Tests ◽

Rule Out

Background: The elongation of styloid process is considered an anomaly which can cause throat pain and cervico-facial pain and trigger a series of symptoms such as dysphagia, odynophagia, facial pain, ear pain, headache, tinnitus and trismus. The present study was undertaken find out the length of styloid process in patients with throat pain.Methods: A prospective study was conducted among 150 patients. A detailed ENT and general examination was done apart from palpation of the styloid along the posterior tonsillar pillar, a routine Hematological tests with estimation of serum calcium levels, and X-ray towne view was done. Results: The female to male ratio was found to be 1.6:1. Of the 150 cases 92 were middle aged females, the severity of symptoms were directly proportional to the length and the thickness of the styloid. The symptoms ranged from foreign body sensation in the throat to cervicofacial pain and otalgia. Serum Calcium levels were elevated in 60% of the cases.Conclusions: Elongation of the styloid being multi-factorial in origin. A strong suspicion is required on the part of the surgeon to rule out this particular entity. A simple palpitation and an x- ray Towne view can establish the diagnosis of elongated styloid process.

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The elongated styliod process as a cause of throat discomfort

The Journal of Laryngology & Otology ◽

10.1017/s0022215100097139 ◽

1985 ◽

Vol 99 (5) ◽

pp. 505-508 ◽

Cited By ~ 31

Author(s):

Pontus Lindeman

Keyword(s):

Foreign Body ◽

Physical Examination ◽

Case History ◽

Styloid Process ◽

Medical Advice ◽

Common Finding ◽

Tonsillar Fossa ◽

Elongated Styloid Process ◽

Common Complaint ◽

Body Sensation

AbstractPain in the neck, radiating towards the ear, together with a foreign body sensation in the throat is a common complaint. A less common finding upon physical examination is an elongated styloid process, palpable in the tonsillar fossa and provoking the symptoms for which the patient is seeking medical advice. The diagnosis of this so-called Eagle's sundrome is described and the case history and treatment of four patients are presented.

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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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Styloid process elongation and calcification in subjects with tmd: clinical and radiographic aspects

Brazilian Dental Journal ◽

10.1590/s0103-64402012000400023 ◽

2012 ◽

Vol 23 (4) ◽

pp. 443-450 ◽

Cited By ~ 20

Author(s):

Kelly Machado de Andrade ◽

Carolina Almeida Rodrigues ◽

Plauto C. Aranha Watanabe ◽

Marcelo Oliveira Mazzetto

Keyword(s):

Orofacial Pain ◽

Panoramic Radiograph ◽

Styloid Process ◽

Eagle’S Syndrome ◽

Linear Measurements ◽

Panoramic Radiographs ◽

Elongated Styloid Process ◽

Cephalometric Radiograph ◽

Lateral Cephalometric Radiograph ◽

Process Length

Knowledge of the Eagle's syndrome shows that its symptoms can be very easily confused with other types of craniomandibular disorders, especially temporomandibular disorders (TMD). The aim of this study was to find a possible correlation between the presence of TMD and elongation of the styloid process as well relate to presence of calcification of the stilohyoid chain. Fifty patients with TMD, confirmed from the RDC/TMD, were examined clinically and radiographically. Radiographic documentation consisted of digital panoramic radiograph and digital lateral cephalometric radiograph. Radiocef software (Radiomemory) was used for the analysis of radiographs by means of specific cephalometric tracing and linear measurements of the styloid process. Each radiograph was traced and measured three times with intervals of 1 month to spread the error. Statistical analysis was performed by Pearson's test (p=0.001) using Biostat 4.0 statistical software. Result showed an incidence of 76% elongation of the styloid process in the sample. There was a correlation between the bilateral measures taken in panoramic radiographs (?<0.001) and also for measures of styloid process length carried out in different panoramic radiographs and lateral cephalometric radiographs (?<0.001). It was concluded that there is prevalence of elongated styloid process in patients with TMD. However, no relationship was found between measurements on the stylohyoid chain and symptoms of headache, orofacial pain, tinnitus and vertigo.

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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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Elongated styloid process in a dry human skull and its relation to the Eagle’s Syndrome: case report and biometrical assessment

Research Society and Development ◽

10.33448/rsd-v9i9.8374 ◽

2020 ◽

Vol 9 (9) ◽

pp. e961998374

Author(s):

Jaiurte Gomes Martins da Silva ◽

Glícia Maria de Oliveira ◽

Ewerton Fylipe de Araújo Silva ◽

Adriane Barbosa Fernandes Silva ◽

Edla Vitória Santos Pereira ◽

...

Keyword(s):

Case Report ◽

Styloid Process ◽

Eagle’S Syndrome ◽

Human Skull ◽

Elongated Styloid Process ◽

Female Individual ◽

Total Length ◽

Anatomical Basis ◽

The Right

The purpose of the present study was to report a case of an elongated styloid process in a dry human skull and present its biometrical values. The styloid processes of the skull from an 80-year-old Brazilian female individual were inspected and 10 measures were performed bilaterally. Despite small differences between the right and left styloid processes regarding the antero-posterior and lateral-medial widths on the three thirds measured, one must highlight the considerable differences showed on the total length of the styloid process (left side: 65.94; right side: 28.90) and on the length of the sheath of the styloid process, which was of 30.01mm on the left side and it was not acquired on the right side because of its small dimensions. The paper discusses its findings from an anatomical and clinical perspectives, providing anatomical basis for a better understanding of the Eagle’s syndrome.

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Own experience in the diagnosis and treatment of elongated styloid process syndrome

Otolaryngologia Polska ◽

10.5604/01.3001.0014.3666 ◽

2020 ◽

Vol 74 (6) ◽

pp. 1-5

Author(s):

Magdalena Wacławek ◽

Piotr Pietkiewicz ◽

Piotr Niewiadomski ◽

Jurek Olszewski

Keyword(s):

Treatment Time ◽

Correct Diagnosis ◽

Styloid Process ◽

The Body ◽

Eagle’S Syndrome ◽

Elongated Styloid Process ◽

Intraoral Approach ◽

Cosmetic Effect ◽

Male Patients ◽

Medical University

Introduction: The aim of the study was to present selected cases with Eagle’s syndrome diagnosed and treated at the Department of Otolaryngology, Laryngological Oncology, Audiology and Phoniatrics, Medical University of Lodz, in the years 2016–2020. Material and method: Five selected clinical cases with Eagle’s syndrome are presented, including three male patients and two female patients, aged 28 to 42 years. Results: The prevalence of Eagle’s syndrome was similar for both female and male patients. The carotid artery syndrome, which is characterized by: visual disturbances, unilateral pain located along cervical vessels, headache and migraine, was more common. Lack of proper diagnosis of Eagle’s syndrome often significantly delays the implementation of proper treatment and thus exposes patients to long-term struggle with pain. Our observations have shown that the time between the onset of symptoms and correct diagnosis in patients averaged about five years. 3D-CT scan is the gold standard for detecting Eagle’s syndrome. An intraoral approach was used in surgical treatment. Although this approach offers shorter treatment time and better cosmetic effect, there is also a greater risk of complications associated with limited visibility of the surgical field and infection. Conclusions: Although styloid syndrome usually occurs bilaterally, these patients reported unilateral symptoms. No correlations were found between the prevalence of Eagle’s syndrome and sex, the length of the styloid process or age, nor side of the body. The best healing effect is obtained by surgical correction/reduction of the elongated styloid process.

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