Eagle syndrome as a cause of transient ischemic attacks

Eagle syndrome is an uncommon entity but is well known in the otorhinolaryngology and oral surgery literature. This syndrome results from the compression of cranial nerves in the neck by an elongated styloid process causing unilateral cervical and facial pain. The styloid process can also cause compression of the cervical carotid arteries leading to the so-called carotid artery syndrome together with carotidynia or neurological symptoms due to flow reduction in these arteries. The authors discuss the case of a 70-year-old man who suffered from transient ischemic attacks on turning his head to the left, with immediate remission of symptoms when his head returned to the neutral position. The patient was studied with dynamic angiography, which clearly showed focal flow restriction. Once a diagnosis was made, the styloid process was removed surgically and the patient completely recovered from his symptoms. A postoperative angiogram demonstrated complete resolution of the pathology. Neurosurgeons might encounter patients with Eagle syndrome and should be aware of the symptoms and signs. Once the diagnosis is made, the treatment is clear and very effective.

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Eaglov sindrom

Slovenian Medical Journal ◽

10.6016/zdravvestn.1894 ◽

2017 ◽

Vol 86 ◽

Author(s):

Mladen Gasparini ◽

Primož Praček ◽

Jani Muha ◽

Uroš Tomić

Keyword(s):

Average Length ◽

Cranial Nerves ◽

Styloid Process ◽

Computed Tomographic Angiography ◽

Measurement Tool ◽

Computed Tomographic ◽

Elongated Styloid Process ◽

Eagle Syndrome ◽

The Right ◽

Tomographic Angiography

Background: In the present article we present the characteristics of Eagle syndrome, which is an often overlooked cause of chronic pain in the neck and head. The syndrome is caused by the compression of an elongated styloid process on the adjacent cranial nerves or the carotid arteries. Since there are disparate data in the literature regarding the proportion of people with an elongated styloid process, we conducted a survey to determine the percentage of patients with an elongated styloid process in a group of subjects who underwent computed tomographic imaging of the neck vessels in our institution.Methods: We analyzed the images of 104 patients who were referred to our institution for computed tomographic angiography of the neck between the years 2014 and 2016. With the help of a software measurement tool, we determined the length of the styloid processes and compared the length of the processes on both sides and in both genders. Patients with an elongated styloid process were reviewed for any symptoms of Eagle syndrome.Results: The average age of the reviewed patients was 67.1 years. Both genders were equally represented (51 % men and 49 % women). The average length of the styloid process was 23.8 (7.0) mm, with 23 patients (22.1 %) having a styloid process longer than 30 mm. In one third of those patients the styloid process was elongated bilaterally. There were no diﬀerences in the average length of the styloid process between men and women and between the left and the right side. Among patients with an elongated styloid process, only one (4.3 %) had symptoms attributable to the Eagle syndrome.Conclusions: Eagle syndrome should be suspected in a patient with repetitive, dull pain in the throat and neck, which worsens during speaking, chewing or swallowing. The diagnosis is confirmed by computed tomography which could demonstrate an elongated styloid process and exclude other causes for neck pain. With regard to the results of our study, an elongated styloid process is found in a relatively high percentage of patients but the condition is only rarely symptomatic.

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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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Elongated Styloid Process as a Cause of Transient Ischemic Attacks

JAMA Neurology ◽

10.1001/jamaneurol.2013.1950 ◽

2013 ◽

Vol 70 (8) ◽

pp. 1072 ◽

Cited By ~ 3

Author(s):

Joon Ho Song ◽

Sung Ki Ahn ◽

Chul Bum Cho

Keyword(s):

Styloid Process ◽

Transient Ischemic Attacks ◽

Elongated Styloid Process

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Entrapment of the glossopharyngeal nerve in patients with Eagle syndrome: surgical technique and outcomes in a series of 5 patients

Journal of Neurosurgery ◽

10.3171/2009.1.jns08485 ◽

2009 ◽

Vol 111 (6) ◽

pp. 1226-1230 ◽

Cited By ~ 21

Author(s):

John H. Shin ◽

Sebastian R. Herrera ◽

Paula Eboli ◽

Sabri Aydin ◽

Emad H. Eskandar ◽

...

Keyword(s):

Pain Relief ◽

Medical Center ◽

Pain Syndrome ◽

Styloid Process ◽

Glossopharyngeal Nerve ◽

Surgical Morbidity ◽

Elongated Styloid Process ◽

Operative Indications ◽

Eagle Syndrome ◽

The Many

Object Eagle syndrome is characterized by unilateral pain in the oropharynx, face, and earlobe, and is caused by an elongated styloid process or ossification of the stylohyoid ligament with associated compression of the glossopharyngeal nerve. The pain syndrome may be successfully treated with surgical intervention that involves resection of the styloid process. Although nerve decompression is routinely considered a neurosurgical intervention, Eagle syndrome and its treatment are not sufficiently examined in the neurosurgical literature. Methods A review was performed of cases of Eagle syndrome treated in the Department of Neurosurgery at the University of Illinois at Chicago Medical Center over the last 7 years. The clinical characteristics, radiographic imaging, operative indications, procedural details, surgical morbidity, and clinical outcomes were collected and analyzed. Results Of the many patients with facial pain treated between 2001 and 2007, 7 were diagnosed with Eagle syndrome, and 5 of these patients underwent resection of the elongated styloid process. There were 4 women and 1 man, ranging in age from 20 to 68 years (mean 43 years). The average duration of disease was 11 years. In all patients, a preoperative workup revealed unilateral or bilateral elongation of the styloid process. All patients underwent resection of the styloid process on the symptomatic side using a lateral transcutaneous approach. There were no surgical complications. All patients experienced pain relief immediately after the operation. At the latest follow-up (average 46 months, range 7 months to 7.5 years) all but 1 patient maintained complete pain relief. In 1 patient, the pain recurred 12 months postoperatively and additional interventions were required. Conclusions Eagle syndrome may be considered an entrapment syndrome of the glossopharyngeal nerve. It is a distinct clinical entity that should be considered when evaluating patients referred for glossopharyngeal neuralgia. The authors' experience indicates that patients with Eagle syndrome may be successfully treated using open resection of the elongated styloid process, which appears to be both safe and effective in terms of long-lasting pain relief.

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Internal carotid dissection caused by an elongated styloid process (Eagle syndrome)

BMJ Case Reports ◽

10.1136/bcr-2013-009878 ◽

2013 ◽

Vol 2013 (jun11 1) ◽

pp. bcr2013009878-bcr2013009878 ◽

Cited By ~ 21

Author(s):

O. Sveinsson ◽

N. Kostulas ◽

L. Herrman

Keyword(s):

Internal Carotid ◽

Styloid Process ◽

Carotid Dissection ◽

Elongated Styloid Process ◽

Eagle Syndrome

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A Case of a Very Elongated Styloid Process

Clinical Medicine Insights Ear Nose and Throat ◽

10.1177/1179550617728899 ◽

2017 ◽

Vol 10 ◽

pp. 117955061772889

Author(s):

YaLi Liu ◽

Huaian Yang ◽

Xiangguo Cui

Keyword(s):

Treatment Process ◽

Styloid Process ◽

Chief Complaint ◽

Chinese Woman ◽

Recurrent Pain ◽

Elongated Styloid Process ◽

Frequent Episodes ◽

Intraoral Approach ◽

Eagle Syndrome ◽

Stylohyoid Ligament

Eagle syndrome is characterized by recurrent pain in the oropharynx and face due to an elongated styloid process or calcified stylohyoid ligament. In this article, we experienced a case of an elongated styloid process which is very rare in size and detailed treatment process. The patient was a 53-year-old Chinese woman with a chief complaint of frequent episodes of radiating pain in left preauricular region for 2 years. An intraoral approach was chosen to shorten part of her styloid process, and the chief complaint disappeared immediately after the operation.

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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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Elongated Styloid Process: Mapping the incidence in Greek population

International Journal of Anatomy and Research ◽

10.16965/ijar.2021.124 ◽

2021 ◽

Vol 9 (2.2) ◽

pp. 7994-8000

Author(s):

Vasilopoulos Anastasios ◽

◽

Tsoucalas Gregory ◽

Thomaidis Vasileios ◽

◽

...

Keyword(s):

Head And Neck ◽

Steel Wire ◽

Styloid Process ◽

Greek Population ◽

Elongated Styloid Process ◽

Stylomastoid Foramen ◽

Close Proximity ◽

Eagle Syndrome ◽

Different Populations ◽

The Right

Background: Styloid process (SP) is a needle shaped projection of the temporal bone, which lies in close proximity to several important anatomical structures of the head and neck. It attracts the attention of anatomists, otolaryngologists and head and neck surgeons, as an abnormally long SP is linked with a clinical condition known as Eagle Syndrome. There are numerous studies in the literature investigating morphometric characteristics of SP, including its length in different populations. The aim of this study is to investigate the incidence of SP elongation in Greek population and to construct an epidemiologic map showing the incidence of SP elongation across different regions of Greek territory. Materials and methods: Two hundred and nine skulls retrieved from cemeteries across Greece were meticulously examined. Ninety-four male skulls and one-hundred and fifteen females, all of Hellenic origin. SP length was measured from the lowest inner point of the surface between the SP and the stylomastoid foramen to its tip, utilizing a digital caliper and a steel wire. Data from this study were statistically analyzed and combined with data from other studies in Greek population in order to construct a detailed epidemiologic map. Results: The mean length was 27.26 ± 5.89 mm for the left and 27.84 ± 6.31 mm for the right SP. In males 36.4% of the left and 37.8% of the right SP were elongated. In females the incidence of SP elongation was 14.3% and 15.5% for left and right side respectively. Statistically significant association was observed between gender and SP length but not between age and SP length. Conclusion: This study enriches the literature by adding information about elongated SP incidence in Greek population. It reviews the existing studies about SP length in Greeks and presents an epidemiologic map showing the incidence of SP elongation across different regions in Greece. KEY WORDS: Skull, Eagle syndrome, Hellenic population, Elongated Styloid Process.

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PROCESSO ESTILOIDE ALONGADO NAS RADIOGRAFIAS PANORÂMICAS EM UMA SUBPOPULAÇÃO

Revista UNINGÁ ◽

10.46311/2318-0579.58.euj3940 ◽

2021 ◽

Vol 58 (1) ◽

pp. eUJ3940

Author(s):

Pedro Luiz de Carvalho ◽

◽

Antônio Martins do Amaral Neto ◽

Larissa Victória Barbosa Freitas ◽

Kunihiro Saito ◽

...

Keyword(s):

Styloid Process ◽

Apparent Size ◽

Type I ◽

Type Ii ◽

Process Data ◽

Chi Square ◽

Significance Level ◽

Panoramic Radiographs ◽

Elongated Styloid Process ◽

Eagle Syndrome

Styloid process elongation associated with symptoms such as cervicofacial pain, tinnitus and otalgia is called Eagle Syndrome. The objective of this study is to assess the presence of elongated styloid process through panoramic radiographs, in a subpopulation of the State of Para, Brazil, as to age and sex. Panoramic radiographs were selected and the apparent size of the styloid process was measured from the point where the styloid leaves the tympanic plate to the lower tip of the process. Data were analyzed by means of chi-square tests and the “t” test with a significance level of 5%. Forty-three percent of all elongated styloid processes were observed in patients aged between 18 and 35 years old. Of these styloid processes measuring more than 30 mm, there were 815 that showed a Type I elongation pattern, being 98 that showed a Type II calcification pattern and 92 showed a Type III calcification pattern. It is concluded that the Type I elongated styloid process was the most frequent, but no statistically significant correlation was found between the presence of the elongated styloid process and the studied variables.

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Styloid process elongation in a sample of Lebanese population: a consideration for the prevention of Eagle syndrome

Medicine and Pharmacy Reports ◽

10.15386/mpr-1666 ◽

2020 ◽

Author(s):

Georges Aoun ◽

Nour Srour ◽

Abbass El-Outa ◽

Ibrahim Nasseh

Keyword(s):

Retrospective Study ◽

Population Sample ◽

Styloid Process ◽

Common Finding ◽

Panoramic Radiographs ◽

Elongated Styloid Process ◽

Lebanese Population ◽

Eagle Syndrome ◽

The Right

Background. The objective of this study was to investigate the prevalence and patterns of styloid process elongation in a general Lebanese population sample. Methods. Digital panoramic radiographs of 489 Lebanese adults (218 males and 271 females, mean age of 47.56 ± 16.149) were included in this retrospective study. First, we screened for detection of elongated styloid process, then we analyzed these cases and classified the elongation types. Data obtained were transformed into SPSS v24 and descriptive and inferential analyses were done. Results. In our sample, elongated styloid process was seen in 76 cases (15.5%) (45/271 women and 31/218 men). Despite no significant gender predisposition, females were slightly more affected than males (59.2% females to 40.8% males). As for the age, elongation was significantly more likely to be present at 45-64 years of age. The right side was slightly more affected than the left side (86.8% vs. 76.3% respectively), with type 1 elongation as the most common. Nevertheless, bilateral elongation was much more common than unilateral elongation (63.2%). Interestingly, females were more likely to suffer from bilateral elongation (64.58%) compared to men (35.41%). Conclusion. Elongated styloid process represents a common finding detected fortuitously on panoramic radiographs. Therefore, being a main feature in Eagle syndrome, dentists should be aware of this clinical entity and actively screen for it.

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