European Archives of Oto-Rhino-Laryngology

, Volume 276, Issue 12, pp 3453–3459 | Cite as

Morphometric examination of the styloid process by 3D-CT in patients with Eagle syndrome

  • Veysel Atilla Ayyildiz
  • Fatih Ahmet Senel
  • Ahmet Dursun
  • Kenan OzturkEmail author
Head and Neck



This study aimed to obtain the length, medial-anterior angulation and basis-apex coordinates of the styloid process in patients with Eagle syndrome by three-dimensional computed tomography.


This study was performed on three-dimensional computed tomography images obtained from the hospital picture archiving and communication system (by obtaining 3D images by a RadiAnt DICOM viewer 4.6.9 version). In this study, the anterior and lateral lengths of the styloid process, its anterior and medial angulation, and the coordinate values on the x, y, and z-axes of 24 patients (14 males, 10 females) diagnosed with Eagle syndrome were examined.


The mean anterior lengths were found to be 41.45 mm on the right and 36.07 mm on the left sides, while the mean lateral lengths were found to be 42.15 mm on the right and 37.59 mm on the left sides. The mean medial angulation was measured to be 62.91° on the right and 63.42° on the left, while mean anterior angulation was measured to be 28.01° on the right and 30.43° on the left. The styloid process basis coordinates were determined as (right: x = − 41.30, y = 0, z = 0, left: x = 40.79, y = 0, z = 0), and apex coordinates were determined as (right: x = − 22.61, y = − 36.86, z = − 19.52, left: x = 24.90, y = − 32.14, z = − 18.65).


Knowing the styloid process basis and apex coordinates in addition to knowing the its length and angulation will be useful in diagnosing Eagle syndrome. We think that these results in relation to the coordinates of the styloid process will bring a new perspective to clinicians who investigate the length and angulation of the styloid process.


Styloid process Angulation Computed tomography Coordinate Matlab 


Author contributions

Methodology: (VAA), (FAŞ); formal analysis and investigation: (AD), (FAŞ); writing—original draft preparation: (VAA), (KÖ); writing—review and editing: (VAA), (KÖ).


This research received no specific grant from any funding agency in the public, commercial, or not for-profit sectors.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

“This article does not contain any studies with human participants or animals performed by any of the authors”. Approval was obtained from Süleyman Demirel University Faculty of Medicine Clinical Research Ethics Committee (Date: 04.05.2019 Decision no: 130).

Supplementary material

405_2019_5602_MOESM1_ESM.xlsx (16 kb)
Supplementary file1 (XLSX 16 kb)


  1. 1.
    Shankar PR, Ananthi KS, Krishanan PLR (2018) Bilateral elongated styloid process in human dry skull. SRM J Res Dent Sci 9:26–28. CrossRefGoogle Scholar
  2. 2.
    Hettiarachchi PVKS, Jayasinghe RM, Fonseka MC, Jayasinghe RD, Nanayakkara CD (2019) Evaluation of the styloid process in a Sri Lankan population using digital panoramic radiographs. J Oral Biol Craniofacial Res 9:73–76. CrossRefGoogle Scholar
  3. 3.
    Baylan H (2017) The anatomical basis of the symptoms of an elongated styloid process. J Hum Rhythm 3:32–35Google Scholar
  4. 4.
    Mortellaro C, Biancucci P, Picciolo G, Vercellino V (2002) Eagle’s syndrome: importance of a corrected diagnosis and adequate surgical treatment. J Craniofac Surg 13:755–758CrossRefGoogle Scholar
  5. 5.
    Badhey A, Jategaonkar A, Kovacs AJA, Kadakia S, De Deyn PP, Ducic Y, Schantz S, Shin E (2017) Eagle syndrome: a comprehensive review. Clin Neurol Neurosurg 159:34–38. CrossRefPubMedGoogle Scholar
  6. 6.
    Shayganfar A, Golbidi D, Yahay M, Nouri S, Sirus S (2018) Radiological evaluation of the styloid process length using 64-row multidetector computed tomography scan. Adv Biomed Res 7:85. CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Balcioglu HA, Kilic C, Akyol M, Ozan H, Kokten G (2009) Length of the styloid process and anatomical implications for Eagle’s syndrome. Folia Morphol (Warsz) 68:265–270Google Scholar
  8. 8.
    Kailasam S, Massillamani F, Potluri VLA, Prabakaran A, Guntuku NL, Priya CV (2018) Morphometric evaluation of styloid process using cone beam computed tomography—a retrospective study of Chennai population. J Adv Med Med Res 25:1–12. CrossRefGoogle Scholar
  9. 9.
    Zokaris N, Siska I, Natsis K, Piagkou M, Lazaridis N, Skolka A, Piehslinger E (2019) Investigation of the styloid process length in a Greek population. Folia Morphol (Warsz) 78:378–388CrossRefGoogle Scholar
  10. 10.
    Andrade KMD, Rodrigues CA, Watanabe PCA, Mazzetto MO (2012) Styloid process elongation and calcification in subjects with TMD: clinical and radiographic aspects. Braz Dent J 23:443–450CrossRefGoogle Scholar
  11. 11.
    Burulday V, Akgul MH, Bayar Muluk N, Yagdiran B, Inal M (2017) The importance of medial-lateral styloid process angulation/coronal plane angle in symptomatic Eagle syndrome. Clin Anat 30:487–491. CrossRefPubMedGoogle Scholar
  12. 12.
    Kosar MI, Atalar MH, Sabanciogullari V, Tetiker H, Erdil FH, Cimen M, Otag I (2011) Evaluation of the length and angulation of the styloid process in the patient with pre-diagnosis of Eagle syndrome. Folia Morphol (Warsz) 70:295–299Google Scholar
  13. 13.
    Okur A, Ozkiris M, Serin HI, Gencer ZK, Karaçavuş S, Karaca L, Kantarcı M, Saydam L (2014) Is there a relationship between symptoms of patients and tomographic characteristics of styloid process? Surg Radiol Anat 36:627–632. CrossRefPubMedGoogle Scholar
  14. 14.
    Frommer J (1974) Anatomic variations in the stylohyoid chain and their possible clinical significance. Oral Surg Oral Med Oral Pathol 38:659–667. CrossRefPubMedGoogle Scholar
  15. 15.
    Piagkou MN, Anagnostopoulou S, Kouladouros K, Piagkos G (2009) Eagle’s syndrome: a review of the literature. Clin Anat 22:545–558. CrossRefPubMedGoogle Scholar
  16. 16.
    Mazzetto MO, De Andrade KM, Magri LV, Rodrigues CA, Watanabe PCA (2013) Anterior and medial angulations of the styloid process in subjects with TMD: clinical and radiographic findings. Braz Dent J 24:80–84. CrossRefPubMedGoogle Scholar
  17. 17.
    Kent DT, Rath TJ, Snyderman C (2015) Conventional and 3-dimensional computerized tomography in Eagle’s syndrome, glossopharyngeal neuralgia, and asymptomatic controls. Otolaryngol Head Neck Surg 153:41–47. CrossRefPubMedGoogle Scholar
  18. 18.
    Yavuz H, Caylakli F, Yildirim T, Ozluoglu LN (2008) Angulation of the styloid process in Eagle’s syndrome. Eur Arch Otorhinolaryngol 265:1393–1396. CrossRefPubMedGoogle Scholar
  19. 19.
    Pokharel M, Karki S, Shrestha I, Shrestha BL, Khanal K, Amatya RCM (2013) Clinicoradiologic evaluation of Eagle’s syndrome and its management. Kathmandu Univ Med J 11:305–309CrossRefGoogle Scholar
  20. 20.
    Ramadan SU, Gokharman D, Tuncbilek I, Kacar M, Koşar P, Kosar U (2007) Assessment of the stylohoid chain by 3D-CT. Surg Radiol Anat 29:583–588. CrossRefPubMedGoogle Scholar
  21. 21.
    Onbas O, Kantarci M, Murat Karasen R, Durur I, Cinar Basekim C, Alper F, Okur A (2005) Angulation, length, and morphology of the styloid process of the temporal bone analyzed by multidetector computed tomography. Acta radiol 46:881–886. CrossRefPubMedGoogle Scholar
  22. 22.
    Başekim CÇ, Mutlu H, Gungor A, Şilit E, Pekkafali Z, Kutlay M, Çolak A, Öztürk E, Kizilkaya E (2005) Evaluation of styloid process by three-dimensional computed tomography. Eur Radiol 15:134–139. CrossRefPubMedGoogle Scholar
  23. 23.
    Buyuk C, Gunduz K, Avsever H (2018) Morphological assessment of the stylohyoid complex variations with cone beam computed tomography in a Turkish population. Folia Morphol (Warsz) 77:79–89. CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Radiology, Faculty of MedicineSuleyman Demirel UniversityIspartaTurkey
  2. 2.Department of Computer Engineering, Engineering FacultySuleyman Demirel UniversityIspartaTurkey
  3. 3.Department of Anatomy, Faculty of MedicineSuleyman Demirel UniversityIspartaTurkey

Personalised recommendations