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

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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Incidence of the Type and Calcification Patterns in Patients with Elongated Styloid Process

Journal of International Medical Research ◽

10.1177/147323000503300110 ◽

2005 ◽

Vol 33 (1) ◽

pp. 96-102 ◽

Cited By ~ 58

Author(s):

M Ilgüy ◽

D Ilgüy ◽

N Güler ◽

G Bayirli

Keyword(s):

Styloid Process ◽

Type I ◽

Frequent Patterns ◽

Eagle’S Syndrome ◽

Radiographic Evidence ◽

Panoramic Radiographs ◽

Male Ratio ◽

Elongated Styloid Process ◽

The Mean ◽

The Right

We investigated the incidence of elongated styloid process (Eagle's syndrome) using panoramic radiographs taken of 860 patients referred to our clinic. Any styloid process identified was classified according to its length, type and the pattern of calcification. Fifty-nine elongated styloid processes were identified in 32 patients (3.7%), most being bilateral; 24 patients were female and eight were male (female/male ratio: 3:1). The mean age of these patients was 43 ± 14 years (range: 18 − 78 years). Type I (elongated) was the most frequent type on both sides (42/59); and the most frequent patterns of calcification were partially calcified on the left side (18/59) and completely calcified on the right side (16/59). Only two patients were symptomatic. A corrected differential diagnosis is important to distinguish elongated styloid process from other pathologies with partially overlapping symptoms. We would recommend that clinicians consider the possibility of Eagle's syndrome when both the clinical and radiographic evidence support this diagnosis.

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Styloid Process: What Length Is Abnormal?

Galician Medical Journal ◽

10.21802/gmj.2021.1.4 ◽

2021 ◽

Vol 28 (1) ◽

pp. E202114

Author(s):

Omair Shah ◽

Faiz Shera ◽

Naseer Choh ◽

Tariq Gojwari ◽

Fahad Shafi ◽

...

Keyword(s):

Computed Tomography ◽

Styloid Process ◽

Group Iv ◽

Eagle’S Syndrome ◽

Group Iii ◽

Elongated Styloid Process ◽

Group I ◽

The Mean ◽

Group Ii ◽

Process Length

The length of the styloid process varies greatly in different populations and depends on ethnicity and geographical background. The elongated styloid process may be associated with Eagle’s syndrome. Therefore, the mean normal length of the styloid process in different population groups needs to be calculated and the upper cutoff limit for elongated styloid process should be found. The objective of the research was to evaluate the styloid process length in the Kashmiri population using multidetector computed tomography. Materials and Methods. We retrospectively evaluated 304 patients who underwent computed tomography of the head and paranasal sinuses, and the mean styloid process length was calculated on both sides. The mean of three measurements of styloid process length was taken. The study population was grouped as follows: Group I included patients at the age of 21-30 years; Group II comprised patients at the age of 31-40 years; Group III included 68 patients at the age of 41-50 years; Group IV comprised patients > 50 years old. Results. The mean length of the styloid process in the studied population varied from 20 to 51 mm (mean 31.3 ± 4.5 mm). There was no significant difference in the length on both sides (p=0.835). The mean length of the styloid process was 30.1 ± 4.2 mm in females and 32.3 ± 4.8 mm in males (p< 0.034). The lengths of the styloid process in different age groups were as follows: in Group I - 30.9 ± 4.4 mm; in Group II - 31.2 ± 4.8 mm; in Group III - 31.6 ± 4.3 mm; in Group IV - 31.5 ± 4.5 mm. Conclusions. The mean length of the styloid process in our population was higher as compared to many other ethnic groups. The styloid process in males was longer. The elongated styloid process on computed tomography scan should not be labeled as Eagle’s syndrome unless clinical symptoms are present.

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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 ◽

Elongated Styloid Process ◽

Surgical Reduction ◽

Uncommon Condition ◽

Stylohyoid Ligament

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

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Does the Panoramic Radiography Have the Power to Identify the Gonial Angle in Orthodontics?

The Scientific World JOURNAL ◽

10.1100/2012/219708 ◽

2012 ◽

Vol 2012 ◽

pp. 1-4 ◽

Cited By ~ 10

Author(s):

Rıdvan Okşayan ◽

Ali Murat Aktan ◽

Oral Sökücü ◽

Esin Haştar ◽

Mehmet Ertuğrul Ciftci

Keyword(s):

Panoramic Radiography ◽

Panoramic Radiograph ◽

Class I ◽

Panoramic Radiographs ◽

Gonial Angle ◽

Cephalometric Radiograph ◽

Orthodontic Patients ◽

Lateral Cephalometric Radiograph ◽

Inferior Border ◽

Age Range

Purpose. The objective of this study was to assess gonial angle under the angle classification by comparing panoramic radiograph and lateral cephalometric radiograph.Materials and Methods. 49 patients (25 males, 24 females) with an age range of 12–29 years participated in the present study. Subjects were retrospectively selected among those categorised as skeletal and dental Class I, II, and III malocclusion group. Using lateral cephalometric radiograph, mandibular and ramal planes were drawn and based on these planes. Gonial angle was determined from two tangents which were drawn from the inferior border of the mandible and posterior borders of the condyle and ramus of both sides in the panoramic radiographs. Multiple comparison tests (ANOVA) were used to determine differences between the three angle groups.Results. There were no significant differences between Class I, II, and III malocclusion group values of gonial angles determined by lateral cephalometric radiograph and panoramic radiographs ().Conclusion. Panoramic radiograph results were shown to be as reliable as lateral cephalometric radiograph in all angle classifications. Panoramic radiography can be used as an alternative radiographic technique to detect gonial angle in orthodontic patients.

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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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Occurrence of the Elongated Styloid Process on Digital Panoramic Radiographs in the Riyadh Population

Radiology Research and Practice ◽

10.1155/2021/6097795 ◽

2021 ◽

Vol 2021 ◽

pp. 1-5

Author(s):

Lingam Amara Swapna ◽

Nada Tarek AlMegbil ◽

Alhanouf Othman Almutlaq ◽

Pradeep Koppolu

Keyword(s):

Demographic Data ◽

Randomized Study ◽

Age Groups ◽

Styloid Process ◽

Panoramic Radiographs ◽

Elongated Styloid Process ◽

Digital Radiographs ◽

Dental Hospital ◽

Orofacial Region ◽

Measuring Tool

Background. Patients with an elongated styloid process might present with dysphagia and pain in the cervicofacial region. These patients could be misdiagnosed as other orofacial pathologies. Aim. The present study attempted to assess the prevalence of the elongated styloid process on digital panoramic radiographs in the Riyadh population. Materials and Methods. The present prospective randomized study was conducted on the panoramic digital radiographs of 300 randomly selected patients visiting a private dental hospital to identify any elongation of the styloid process. Only the radiographs without any magnification errors were considered. The styloid process length was measured using the Sidexis measuring tool and entered in an Excel spreadsheet with other demographic data. A length beyond 30 mm was considered styloid process elongation. The data were subjected to statistical analysis. Results. The symptoms of styloid process elongation were higher among females (78.6%), and this difference was statistically significant (χ2 = 7.182; P = 0.007 ). No statistically significant association was observed between styloid process elongation and symptoms between different age groups. Females exhibited a significant longer mean length of the styloid process than males. The present study exhibited a 27.3% prevalence for the elongation and calcification of the styloid process. Conclusion. Given the significant prevalence of the elongated styloid process in our study, we recommend it to be considered as one of the differential diagnosis for pain or discomfort in the orofacial region.

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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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Elongated styloid process: An epidemiological study on digital panoramic radiographs

Journal of Clinical and Experimental Dentistry ◽

10.4317/jced.54370 ◽

2017 ◽

pp. 0-0 ◽

Cited By ~ 3

Author(s):

G Bruno ◽

A De Stefani ◽

P Balasso ◽

S Mazzoleni ◽

A Gracco

Keyword(s):

Epidemiological Study ◽

Styloid Process ◽

Panoramic Radiographs ◽

Elongated Styloid Process

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Prevalence of elongated styloid process in Saudi population of Aseer region

European Journal of Dentistry ◽

10.4103/1305-7456.120687 ◽

2013 ◽

Vol 07 (04) ◽

pp. 449-454 ◽

Cited By ~ 11

Author(s):

Mohammed Asif Shaik ◽

Sultan Mohammed Kaleem ◽

Abdul Wahab ◽

Shahul Hameed ◽

Keyword(s):

Age Groups ◽

Styloid Process ◽

Frequent Pattern ◽

P Value ◽

Type I ◽

Saudi Population ◽

Radiographic Appearance ◽

Panoramic Radiographs ◽

Elongated Styloid Process ◽

Significant Difference

ABSTRACT Objective: The study was performed to investigate the prevalence, morphology and calcification pattern of elongated styloid process in Saudi population of Aseer (Southern) region and its relation to gender and sub-age groups. Materials and Methods: This study was analyzed digital panoramic radiographs of 1,162 adults. Any radiograph with questionable styloid process was excluded from the study. The apparent length of the styloid process was measured by a single experienced dental and maxillofacial Radiologist. The elongated styloid process was classified with the radiographic appearance based on the morphology and calcification pattern. The data were analyzed by using Student′s t-test and Chi-square test with P value less than 0.05. Results: A total of 1,085 Digital panoramic radiographs showed elongated styloid process of which 686 (63.2%) were noticed in males and 399 (36.8%) were noticed in female patients. There was a statistical significant difference noticed in the mean difference of elongated styloid process between 20-29, 50-59 and 60 years and above sub-age groups. The elongated styloid process was more prevalent in elderly aged male patients (P < 0.05). Type I morphology with calcified out line (a) was the most frequent pattern of calcification noticed in the present study.Conclusion: The panoramic radiographs are economical, easily accessible and useful diagnostic tool for early detection of elongated styloid process with or without symptoms. However, studies with larger sample size would further help to assess the prevalence of this elongated styloid process in Saudi population of various other regions.

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