An overview of Eagle’s syndrome

Pain Clinics ◽

Eagle’s syndrome is a condition that typically does not present to pain clinics. It consists of an elongated styloid process greater than 25 mm and/or stylohyoid ligament calcification causing an unusual array of symptoms, relating to anatomical involvement. Multiple specialities may be involved with the diagnosis of this rare condition. Three-dimensional reconstructive computed tomographic (CT) scan remains the gold standard for diagnosis. Depending on the presenting symptoms, care should be directed to an appropriate specialist. Pain surrounding Eagle’s syndrome does not typically resolve using simple pharmacological methods. Eagle’s syndrome should remain a diagnosis to be considered when faced with non-resolving head/facial pain.

Styloidectomy: our experience with intraoral approach

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20204639 ◽

2020 ◽

Vol 6 (11) ◽

pp. 2106

Author(s):

Purigali S. Maradesha ◽

Subash Chandrashekhar ◽

Samatha K. Jayaramaiah

Keyword(s):

Retrospective Study ◽

Local Anesthesia ◽

Styloid Process ◽

Study Group ◽

Eagle’S Syndrome ◽

Quick Recovery ◽

Intraoral Approach ◽

Symptom Complex ◽

Background: Eagle’s syndrome is a symptom complex arising due to elongated styloid process or calcification of stylohyoid ligament. Surgical treatment is regarded as the foremost option. The study aims to put forth our experience with intraoral approach to styloidectomy in 17 subjects.Methods: A retrospective study was conducted between January 2017 to December 2019. The study included 17 subjects with a diagnosis of elongated styloid process. All the subjects underwent styloidectomy by intraoral approach and were followed up.Results: In our study, the median age of the study group was 33.76 and out of 17 subjects 13 were female and 4 male. The procedure was done under local anesthesia in 13 subjects and under general anesthesia in 4 subjects. Styloidectomy by intraoral approach was done in all subjects among which 15 were bilateral and 2 unilateral. 88% of the subjects were symptom free by third week.Conclusions: The study suggests that styloidectomy by intraoral approach is minimally invasive and can be done under local anesthesia with an added advantage of quick recovery.

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 ◽

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

Endoscopic transoral resection of an elongated styloid process: a case report

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20183709 ◽

2018 ◽

Vol 4 (5) ◽

pp. 1317

Author(s):

Shilpa H. ◽

Amrita Suzanne Mathew ◽

Sandhya Hemraj ◽

Aishwarya Sridhar

Keyword(s):

Case Report ◽

3D Reconstruction ◽

Surgical Excision ◽

Styloid Process ◽

3D Ct ◽

Computerised Tomography ◽

Eagle’S Syndrome ◽

Stylohyoid Ligament ◽

Transoral Resection

Eagle’s syndrome is an aggregate of craniocervicofacial symptoms due to an elongated styloid process/calcified stylohyoid ligament. Adequate history, clinical and radiological examination, and sound knowledge of mimicking pathology can help in its diagnosis. Computerised tomography (CT) with 3D reconstruction is the most accurate investigation currently available. Treatment can be either surgical or non-surgical. Surgical excision of the abnormally elongated styloid process is preferred. Extraoral and intraoral approaches are available, each with their inherent advantages/disadvantages. Endoscope-assisted transoral resection resolves the disadvantages associated with the latter, representing a favourable advancement. We report a case who presented with craniocervicofacial pain, diagnosed clinically and on 3D-CT with Eagle’s Syndrome, and treated successfully by endoscope-assisted transoral resection.

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

The Syndrome of Elongated Styloid Process, the Eagle’s Syndrome—From Anatomical, Evolutionary and Embryological Backgrounds to 3D Printing and Personalized Surgery Planning. Report of Five Cases

Medicina ◽

10.3390/medicina56090458 ◽

2020 ◽

Vol 56 (9) ◽

pp. 458 ◽

Cited By ~ 1

Author(s):

Ladislav Czako ◽

Kristian Simko ◽

Andrej Thurzo ◽

Branislav Galis ◽

Ivan Varga

Keyword(s):

Internal Carotid ◽

Jugular Vein ◽

Styloid Process ◽

3D Models ◽

Eagle’S Syndrome ◽

Anatomical Structures ◽

Vagal Nerves ◽

3D Printed ◽

Background and Objectives: The symptoms of Eagle’s syndrome are associated with the elongated styloid process of the temporal bone or calcification of the stylohyoid ligament. The first mention of pain syndrome associated with the elongated styloid process dates back to 1937, when it was described by Watt Weems Eagle. Over the last decade, experts in the field have shown a lively interest in the issue of the relationship between the elongated styloid process and various symptoms. This article presents the correlation between the clinical signs of Eagle’s syndrome and alterations in surrounding anatomical structures. It includes a brief review of the evolutionary, embryological and clinical anatomical background of the elongated styloid process. Materials and Methods: Between 2018 and 2019, five patients were admitted to our workplace with 1–3-year history of bilateral or unilateral throat pain, otalgia and pharyngeal foreign body sensation. As a therapeutic novelty in the surgical approach to this condition, we used individual 3D printed models to measure and identify the exact location of the resection of the styloid process without damaging the surrounding anatomical structures, such as the facial, accessory, hypoglossal, and vagal nerves; the internal jugular vein; and the internal carotid artery. Results: Compared to traditional surgical methods without 3D models, 3D models helped to better identify cutting edges and major landmarks used in surgical treatment of Eagle’s syndrome. Printed models provided assistance with the exact location of the styloid process resection position without damaging the surrounding anatomical structures such as the facial, accessory, hypoglossal, and vagal nerves; the internal jugular vein; and the internal carotid artery. Conclusion: In our clinical report, we used 3D printed models for navigation and planning during surgical procedures involving resections of the elongated styloid process. Additionally, we can formulate a new hypothesis: the elongated styloid process is a form of atavism of the bony hyoid apparatus in our evolutionary ancestors that is evolutionarily encoded or arises from disrupted degeneration of the middle portion of embryonal Reichert´s cartilage of the second pharyngeal arch. Under normal conditions, this portion does not ossify but degenerates and transforms into a connective tissue band, the future stylohyoid ligament.

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 ◽

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.

Eagle's syndrome with type III segmented styloid process: A case report

CODS Journal of Dentistry ◽

10.5005/cods-6-1-61 ◽

2014 ◽

Vol 6 (1) ◽

pp. 61-63

Author(s):

Maria Priscilla David ◽

V.A Usha ◽

G.P Mamatha

Keyword(s):

Case Report ◽

Orofacial Pain ◽

Styloid Process ◽

Eagle’S Syndrome ◽

Anatomical Structures ◽

Type Iii ◽

Surgical Reduction ◽

Uncommon Condition ◽

Abstract Eagle's syndrome is not an uncommon condition, but it is less known to Physicians where an elongated styloid process or calcified stylohyoid ligament compresses the adjacent anatomical structures leading to orofacial pain. Pain often gets relieved by surgical reduction of styloid process. Recently depending on the calcification it has been classified as three types. A case of Eagle's syndrome is reported here. How to cite this article Usha VA, Mamatha GP, Maria PD. Eagle's syndrome with type III segmented styloid process. A case report. CODS J Dent 2014;6;61-63

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 ◽

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

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 ◽

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.

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 ◽

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.