scholarly journals Clinicoradiologic Evaluation of Eagle’s Syndrome and its Management

2015 ◽  
Vol 11 (4) ◽  
pp. 305-309 ◽  
Author(s):  
M Pokharel ◽  
S Karki ◽  
I Shrestha ◽  
BL Shrestha ◽  
K Khanal ◽  
...  

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

2020 ◽  
Vol 74 (6) ◽  
pp. 1-5
Author(s):  
Magdalena Wacławek ◽  
Piotr Pietkiewicz ◽  
Piotr Niewiadomski ◽  
Jurek Olszewski

<b>Introduction:</b> 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. <br><b>Material and method:</b> Five selected clinical cases with Eagle’s syndrome are presented, including three male patients and two female patients, aged 28 to 42 years. <br><b>Results:</b> 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. <br><b>Conclusions:</b> 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.


Author(s):  
Purigali S. Maradesha ◽  
Subash Chandrashekhar ◽  
Samatha K. Jayaramaiah

<p><strong>Background:</strong> 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.</p><p><strong>Methods:</strong> 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.</p><p><strong>Results:</strong> 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.</p><p><strong>Conclusions:</strong> 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.<strong></strong></p>


Author(s):  
Shilpa H. ◽  
Amrita Suzanne Mathew ◽  
Sandhya Hemraj ◽  
Aishwarya Sridhar

<p>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.</p>


2007 ◽  
Vol 121 (4) ◽  
pp. 349-353 ◽  
Author(s):  
D R Nayak ◽  
K Pujary ◽  
M Aggarwal ◽  
S E Punnoose ◽  
V A Chaly

Elongated styloid process is a relatively common cause of facial and neck pain, but it is often misdiagnosed due to its varied clinical presentation. Since an elongated styloid process is often confirmed by radiological means, it would be helpful to find a more accurate mode of depicting the styloid process.In this prospective study, 39 cases were evaluated. A three-dimensional computed tomography (3D CT) reconstruction of the styloid process was performed in 18 cases. In these patients, we compared the length and medial angulation of the symptomatic styloid process as viewed on an orthopantomogram and a 3D CT reconstruction.It was noted that a 3D CT reconstruction was more accurate in depicting the styloid process. This investigation can be considered as the ‘gold standard’ in the radiological diagnosis of an elongated styloid process.


Author(s):  
Shibani V. Anchan ◽  
Arunkumar J. S. ◽  
Raghunath Shanbag ◽  
Santosh S. Garag

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">The aim of the study is to correlate the clinical palpability of the styloid process with its length which is determined by CT scan. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">A prospective study of 50 patients who presented to ENT OPD from January 2011 to January 2016 with cervicofacial pain and features of Eagle’s syndrome were clinically evaluated for elongated styloid process by palpating the tonsillar fossa. These patients were subjected to a detailed CT scan with coronal, axial and 3D cuts. The length of the styloid process in the CT scan was correlated with the clinical palpability of the styloid process.  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">It was noticed that only styloid process of length greater than 28 mm was clinically palpable. Correlation between the clinical palpability and the minimum length required was established in this study. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Patients with cervicofacial pain should be evaluated for styalgia by imaging and clinically by palpating the tonsillar fossa.</span></p>


2012 ◽  
Vol 23 (4) ◽  
pp. 443-450 ◽  
Author(s):  
Kelly Machado de Andrade ◽  
Carolina Almeida Rodrigues ◽  
Plauto C. Aranha Watanabe ◽  
Marcelo Oliveira Mazzetto

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.


2021 ◽  
pp. 1-18
Author(s):  
Andres Gonzalez ◽  
Zoya Heidari ◽  
Olivier Lopez

Summary Core measurements are used for rock classification and improved formation evaluation in both cored and noncored wells. However, the acquisition of such measurements is time-consuming, delaying rock classification efforts for weeks or months after core retrieval. On the other hand, well-log-based rock classification fails to account for rapid spatial variation of rock fabric encountered in heterogeneous and anisotropic formations due to the vertical resolution of conventional well logs. Interpretation of computed tomography (CT) scan data has been identified as an attractive and high-resolution alternative for enhancing rock texture detection, classification, and formation evaluation. Acquisition of CT scan data is accomplished shortly after core retrieval, providing high-resolution data for use in petrophysical workflows in relatively short periods of time. Typically, CT scan data are used as two-dimensional (2D) cross-sectional images, which is not suitable for quantification of three-dimensional (3D) rock fabric variation, which can increase the uncertainty in rock classification using image-based rock-fabric-related features. The methods documented in this paper aim to quantify rock-fabric-related features from whole-core 3D CT scan image stacks and slabbed whole-core photos using image analysis techniques. These quantitative features are integrated with conventional well logs and routine core analysis (RCA) data for fast and accurate detection of petrophysical rock classes. The detected rock classes are then used for improved formation evaluation. To achieve the objectives, we conducted a conventional formation evaluation. Then, we developed a workflow for preprocessing of whole-core 3D CT-scan image stacks and slabbed whole-core photos. Subsequently, we used image analysis techniques and tailor-made algorithms for the extraction of image-based rock-fabric-related features. Then, we used the image-based rock-fabric-related features for image-based rock classification. We used the detected rock classes for the development of class-based rock physics models to improve permeability estimates. Finally, we compared the detected image-based rock classes against other rock classification techniques and against image-based rock classes derived using 2D CT scan images. We applied the proposed workflow to a data set from a siliciclastic sequence with rapid spatial variations in rock fabric and pore structure. We compared the results against expert-derived lithofacies, conventional rock classification techniques, and rock classes derived using 2D CT scan images. The use of whole-core 3D CT scan image-stacks-based rock-fabric-related features accurately captured changes in the rock properties within the evaluated depth interval. Image-based rock classes derived by integration of whole-core 3D CT scan image-stacks-based and slabbed whole-core photos-based rock-fabric-related features agreed with expert-derived lithofacies. Furthermore, the use of the image-based rock classes in the formation evaluation of the evaluated depth intervals improved estimates of petrophysical properties such as permeability compared to conventional formation-based permeability estimates. A unique contribution of the proposed workflow compared to the previously documented rock classification methods is the derivation of quantitative features from whole-core 3D CT scan image stacks, which are conventionally used qualitatively. Furthermore, image-based rock-fabric-related features extracted from whole-core 3D CT scan image stacks can be used as a tool for quick assessment of recovered whole core for tasks such as locating best zones for extraction of core plugs for core analysis and flagging depth intervals showing abnormal well-log responses.


2020 ◽  
Vol 9 (1) ◽  
pp. 85-89
Author(s):  
MY Dofe ◽  
◽  
KS Nemade ◽  
NY kamadi ◽  
◽  
...  

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 ◽  
...  

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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