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Styloid syndrome is characterized by an elongated styloid process or calcification of the stylomandibular and stylohyoid ligament. This study describes a case of a 65-year-old woman who presented to the Stomatology Clinic, University of Marilia with temporomandibular joint pain, ear ringing and a reduced ability to open the mouth. Panoramic and pos...
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... main symptoms of classic styloid syndrome include: reduced ability to open the mouth, increased salivation, a foreign-body sensation and pain in the pharynx, and tinnitus. However, an elongated styloid process (Fig. 1) or calcified styloid ligament usually does not cause characteristic symptoms ( Guo et al., ...
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Introduction: The Eagle syndrome is characterized by the elongation of styloid process. This provides attachment for many important neurovascular structures and can lead to a broad spectrum of symptoms. The most common symptoms include odynophagia and a sensation of a foreign body. It can also cause dysphagia, headache, syncope, or even transient i...
Citations
... Calcification of the styloid complex shows great variability in the population [8]. The elongation of the styloid process was considered when it exceeded 30mm from the inferior border of the external acoustic meatus using the digital DPT editing tool [8][9][10][11][12][13]. In our study, this calcification was the most prevalent, and was encountered in a total of 310 cases (13.1%) (table 3 and 4), differing from other radiographic studies found in the literature, where prevalence rates range from 52.1%, 38.57%, 3.7% [8,13,14]. ...
... (table 3). Some studies consider panoramic radiography as the best method of evaluation of this calcification, as it allows the visualisation of both sides simultaneously with its medial angulation [8][9][10]. More than 50% of patients are clinically asymptomatic [1]. ...
... When the styloid process exceeds 30mm in length, measured from the lower edge of the external acoustic meatus, it is considered to be elongated [8][9][10][11][12][13] Radiographically, the ossification extends anterior to the mastoid process and crosses the posterolateral portion of the mandibular branch towards the hyoid bone [8,10,11] ...
Objectives:
To determine the frequency and spectrum of soft tissues calcifications identified on Dental Pantomograms (DPT) at a University Dental Clinic in the northern region of Portugal and to compare the data obtained with those published in the literature.
Methods:
We conducted a 3-year descriptive analysis (2012-2014) of DPT calcifications within soft tissues at the University Clinic (CESPU), in Oporto, Portugal. Information on gender, age, location of the lesions and the radiographic diagnosis were analysed. DPTs were interpreted by two examiners (Kappa test 0.8). Data were entered into a database and analysed with Chi-square and Fisher exact tests. Statistical analysis was performed using the Kolmogorov-Smirnov and Shapiro-Wilk test.
Results:
2375 DPTs were analysed, with 468 calcifications observed in the radiographs of 420 individuals. Calcifications of the stylohyoid and stylomandibular ligament were most common, with atheroma, sialoliths, tonsilloliths rhinoliths and antroliths also identified. A statistically significant relationship was observed between the presence of calcifications of the stylohyoid and stylomandibular ligaments, atheromatous calcifications in the carotid artery and tonsilloliths in individuals older than 40.
Conclusions:
This is the largest sample analysis ever done in Portugal, providing useful information about the incidence and distribution of soft tissue calcifications identifiable on DPTs, allowing valuable comparison with other countries.
... Nevertheless, an elongated styloid process or a calcified styloid ligament usually does not cause characteristic symptoms. [9] Steinmann anticipated diverse theories to explicate ossification. These were: (a) 'Theory of reactive hyperplasia'trauma can cause ossification at the end of the styloid process down the length of the styloid ligament, as the styloid ligament contains remnants of its connective tissue and fibrocartilaginous origins, which are the potential for ossification remains; (b) 'Theory of reactive metaplasia'an abnormal posttraumatic healing response initiates calcification of the stylohyoid ligament; and (c) 'Theory of anatomic variance'the early elongation of the styloid process and ossification of the styloid ligament are anatomical variations that occur without recognizable trauma. ...
Eagle's syndrome is not an uncommon condition, but less known to physicians, where an elongated styloid process or calcified stylohyoid ligament compresses the adjacent anatomical structures leading to orofacial pain. Diagnosis is made with appropriate radiological examination. Nonsurgical treatment options include reassurance, analgesia, and anti-inflammatory medications; and the surgical option includes a transoral or external approach. Here, we present a case report of a male patient, of age38 years, with a chief complaint of unilateral atypical orofacial pain on the right side of his face radiating to the neck region, for the last two months.
... Medial to the tip of the process is located the superior pharyngeal constrictor muscle and the pharyngeal-basilar fascia, adjacent to the tonsillar fossa. Laterally the external carotid artery, then the facial nerve emerging from the stylomastoid foramen, and passing through the parotid gland [1][2][3] . ...
... Nevertheless, Eagle affirms that the normal length of the styloid process is approximately 25 mm, therefore any length superior to this could be considered as elongated. However, some authors consider the styloid process as elongated if its length is greater than 30 mm [1] . ...
Clinical report of a 27-year-old patient diagnosed with trisomy 16 and congenital cervical scoliosis; within the oral clinical manifestations of the disease were found agenesis of upper lateral incisors, ankyloglossia, over-inserted labial frenulum and high and arched palate; also the patient showed generalized marginal gingivitis associated to plaque with a loss of attachment level in dental organs 31 and 41. Partial or complete trisomy 16 is considered non-compatible with life; this anomaly corresponds to 2% of the causes of abortion in the first trimester; SH and DP Roberts Duckett reported a case of survival of 10 months, and in this case, the survival is 27 years.
... Medial to the tip of the process is located the superior pharyngeal constrictor muscle and the pharyngeal-basilar fascia, adjacent to the tonsillar fossa. Laterally the external carotid artery, then the facial nerve emerging from the stylomastoid foramen, and passing through the parotid gland [1][2][3] . ...
... Nevertheless, Eagle affirms that the normal length of the styloid process is approximately 25 mm, therefore any length superior to this could be considered as elongated. However, some authors consider the styloid process as elongated if its length is greater than 30 mm [1] . ...
The styloid process is a thin, long and cylindrical bone projection from the lower surface of the temporal bone, from the junction of the petrous and tympanic parts below the external auditory meatus and just anterior to the mastoid process, measuring 2 to 2.5 cm. It is normally located between the internal and external carotid arteries. It allows the insertion of the stylopharyngeus, stylohyoid and styloglossus muscles, as well as the stylomandibular and stylohyoid ligaments. In cases where the styloid processes are elongated, they can be observed through X-ray examinations, such as lateral and anterior-posterior skull radiographs. In the literature, the panoramic radiography is defined as the most used to diagnose diseases or conditions associated with an elongated process. With this work, 5 cases of elongated styloid processes, the use of panoramic radiography for its diagnosis and its possible dental implications are reported.
Background
Eagle syndrome is caused by an elongated styloid process affecting carotid arteries and cranial nerves. Pain, dysphagia, tinnitus, paresthesia (classic subtype), and neurovascular events (vascular subtype) may be triggered by head movements or arise spontaneously. However, Eagle syndrome remains underappreciated in the neurological community. We aimed to determine the most common neurological and non-neurological clinical presentations in patients with Eagle syndrome and to assess the clinical outcome post-surgical resection in comparison to non-surgical therapies.
Methodology
We conducted a systematic review of patient-level data on adults with Eagle syndrome, following PRISMA guidelines. We extracted data on demographics, presenting symptoms, neurological deficits, radiological findings, and treatments, including outcomes and complications, from studies in multiple indexing databases published between 2000 and 2023. The study protocol is registered with PROSPERO.
Results
In total, 285 studies met inclusion criteria, including 497 patients with Eagle syndrome (mean age 47.3 years; 49.8% female). Classical Eagle (370 patients, 74.5%) was more frequent than vascular Eagle syndrome (117 patients, 23.5%, p < 0.0001). Six patients (1.2%) presented with both variants and the subvariant for four patients (0.8%) was unknown. There was a male preponderance (70.1% male) in the vascular subtype. A history of tonsillectomy was more frequent in classic (48/153 cases) than in vascular (2/33 cases) Eagle syndrome (Odds Ratio 5.2, 95% CI [1.2–22.4]; p = 0.028). By contrast, cervical movements as trigger factors were more prevalent in vascular (12/33 cases) than in classic (7/153 cases) Eagle syndrome (Odds Ratio 7.95, 95% CI [2.9–21.7]; p = 0.0001). Headache and Horner syndrome were more frequent in vascular Eagle syndrome and dysphagia and neck pain more prominent in classic Eagle syndrome (all p < 0.01). Surgically treated patients achieved overall better outcomes than medically treated ones: Eighty-one (65.9%) of 123 medically treated patients experienced improvement or complete resolution, while the same applied to 313 (97.8%) of 320 surgical patients (Odds Ratio 1.49, 95% CI [1.1–2.0]; p = 0.016).
Conclusions
Eagle syndrome is underdiagnosed with potentially serious neurovascular complications, including ischemic stroke. Surgical treatment achieves better outcomes than conservative management. Although traditionally the domain of otorhinolaryngologist, neurologist should include this syndrome in differential diagnostic considerations because of the varied neurological presentations that are amenable to effective treatment.
Objetivo: Realizar el reporte y revisión de los fundamentos teóricos de un caso con síndrome de Eagle. Presentación de Caso: Masculino de 57 años, exfumador, que acudió a consulta por presentar aumento de volumen de la hemicara derecha y disfagia de seis meses. Se asocia además cefalea y dolor en región laterocervical derecha irradiado al oído ipsilateral, desencadenado por la deglución y la masticación. A la exploración física destacaba el dolor a la palpación de ambas fosas amigdalinas, y al realizar maniobra activa y pasiva de movimiento cervical. Se le indica Tomografía Axial Computarizada contrastada de cabeza y cuello, con reconstrucción 3D; en la cual se observa proceso estiloides izquierdo elongado de 104 mm, que llega hasta el hueso hioides y/o calcificación del ligamento estilo-hioideo (Síndrome de Eagle). Conclusión: La Tomografía Computarizada con reconstrucción 3D permite el análisis más detallado de los patrones radiológicos de síndrome de Eagle. Aún cuando su presentación es infrecuente, se debe tener como diagnóstico diferencial en casos de dolor en la región maxilofacial sin una etiología clara.
