Skip to main content

An intraoral surgical approach to the styloid process in Eagle’s syndrome

Oral and Maxillofacial Surgery volume 13, pages 145–151 (2009)Cite this article

Abstract

Purpose

The purpose of this study is to present an alternative method to the extraoral surgical approach to remove the elongated styloid process, the intraoral surgical approach, and discuss their advantages and disadvantages. A literature review is also presented.

Patients and methods

A casuistic of intraoral surgical approach to remove the elongated styloid process is presented in five patients.

Results

Four patients experienced postoperative moderate pain and trismus for 1 week. Bilateral surgery in one patient caused severe trismus, great discomfort, and moderate difficulty in breathing. All were followed up for 6 months and showed complete relief of the oral pharyngeal symptoms and complete improvement in functional ability.

Discussion

The advantages of the external approach are good visualization and reduced possibility of deep neck space infection. The disadvantages are an external scar, longer duration of surgery, and risk of injury to the facial nerve. The advantages of the intraoral approach are that the method is safe, simple, and less time consuming and an external scar is avoided. The disadvantages are possible infection of deep neck spaces, risk of injury to major vessels, and poor visualization.

Conclusions

Intraoral resection of the styloid process is a safe treatment technique of Eagle’s syndrome. It is not recommended the bilateral intervention at the same surgery, because of possible great discomfort at postoperative time.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

References

  1. Beder E, Ozgursoy OB, Karatayli Ozgursoy S (2005) Current diagnosis and transoral surgical treatment of Eagle's syndrome. J Oral Maxillofac Surg 63:1742–1745

    PubMed  Article  Google Scholar 

  2. Buono U, Mangone GM, Michelotti A, Longo F, Califano L (2005) Surgical approach to the stylohyoid process in Eagle's syndrome. J Oral Maxillofac Surg 63:714–716

    PubMed  Article  Google Scholar 

  3. Camarda AJ, Deschamps C, Forest D (1989) I. Stylohyoid chain ossification: a discussion of etiology. Oral Surg Oral Med Oral Pathol 67:508–514

    PubMed  Article  CAS  Google Scholar 

  4. Chase DC, Zarmen A, Bigelow WC, McCoy JM (1986) Eagle’s syndrome: as comparison of intraoral and extraoral surgical approaches. Oral Surg Oral Med Oral Pathol 62:625–629

    PubMed  Article  CAS  Google Scholar 

  5. Correll RW, Jenson JL, Taylor JB, Rhyne RR (1979) Mineralization of the stylohyoid–stylomandibular ligament complex. Oral Surg Oral Med Oral Pathol 48:286–291

    PubMed  Article  CAS  Google Scholar 

  6. Diamond LH, Cottrell DA, Hunter MJ, Papageorge M (2001) Eagle’s syndrome: a report of 4 patients treated using a modified extraoral approach. J Oral Maxillofac Surg 59:1420–1426

    PubMed  Article  CAS  Google Scholar 

  7. Eagle WW (1937) Elongated styloid process: report of 2 cases. Arch Otolaryngol 25:584–587

    Google Scholar 

  8. Eagle WW (1948) Elongated styloid process. Arch Otolaryngol 47:630–640

    PubMed  CAS  Google Scholar 

  9. Eagle WW (1949) Symptomatic elongated styloid process; report of two cases of styloid process-carotid artery syndrome with operation. Arch Otolaryngol 49:490–503

    PubMed  CAS  Google Scholar 

  10. Eagle WW (1958) Elongated styloid process: symptoms and treatment. AMA Arch Otolaryngol 67:172–176

    PubMed  CAS  Google Scholar 

  11. Evans JT, Clainnont AA (1976) The nonsurgical treatment of Eagle's syndrome. Ear Nose Throat J 55:44–45

    Google Scholar 

  12. Fini G, Gasparini G, Filippini F, Becelli R, Marcotullio D (2000) The long styloid process syndrome or Eagle’s syndrome. J Cranio-maxillo-facial Surg 28:123–127

    Article  CAS  Google Scholar 

  13. Fritz M (1940) Elongated styloid process: cause of obscure throat symptoms. Arch Otolaryngol 31:911–918

    Google Scholar 

  14. Frommer J (1974) Anatomic variations in the stylohyoid chain and their possible clinical significance. Oral Surg 38:659–667

    PubMed  Article  CAS  Google Scholar 

  15. Goldstein GR, Scopp IW (1973) Radiographic interpretation of calcified stylomandibular and stylohyoid ligaments. J Prosthet Dent 30:330–334

    PubMed  Article  CAS  Google Scholar 

  16. Goodman RS (1981) Fracture of an ossified stylohyoid ligament. Arch Otolaryngol 107:129–130

    PubMed  CAS  Google Scholar 

  17. Guerrier Y, Rabischong P, Guerrier B (1988) Cours superieur d'anatomie chirurgicale de cou et des glandes salivaires. Ed. Lib. Arnett, Montpellier

    Google Scholar 

  18. Härmä R (1966) Stylalgia: clinical experiences of 52 cases. Acta Otolaryngol Suppl 224:149

    Google Scholar 

  19. Kaufman SM, Elzay RP, Irish EF (1970) Styloid process variation: radiologic and clinical study. Arch Otolaryngol 91:460–463

    PubMed  CAS  Google Scholar 

  20. Keur JJ, Campbell JPS, McCarthy JF, Ralph WJ (1986) The clinical significance of the elongated styloid process. Oral Surg Oral Med Oral Pathol 61:399–404

    PubMed  Article  CAS  Google Scholar 

  21. Lee S, Hillel A (2004) Three-dimensional computed tomography imaging of Eagle’s syndrome. Am J Otolaryngol 25:109

    PubMed  Article  Google Scholar 

  22. Lentini A (1975) Gli aspetti clinici e radiologici delle anomalie dell'apparato stilo-joideo. Radiol Med 61:337–364

    Google Scholar 

  23. Lindeman P (1985) The elongated styloid process as a cause of throat discomfort: four case reports. J Laryngol Otol 99:505–508

    PubMed  Article  CAS  Google Scholar 

  24. Loeser L, Caldwell E (1942) Elongated styloid process: a cause of glossopharyngeal neuralgia. Arch Otolaryngol 36:198–202

    Google Scholar 

  25. Moffat DA, Ramsden RT, Shaw HJ (1977) The styloid process syndrome: aetiological factors and surgical treatment. J Laryngol Otol 91:279–294

    PubMed  CAS  Google Scholar 

  26. Prasad KC, Kamath MP, Reddy KJ, Raju K, Agarwal S (2002) Elongated styloid process (Eagle's syndrome): a clinical study. J Oral Maxillofac Surg 60:171–175

    PubMed  Article  Google Scholar 

  27. Roca A, Armengton M, Gimenez G, Barona R, Basterra J (1992) Tratamiento quirurgico del sindrome de Eagle por via orofarigea. A proposito de un caso. Acta Otorrinolaringol Esp 43:210–212

    PubMed  CAS  Google Scholar 

  28. Russel TE (1977) Eagle’s syndrome: diagnostic consideration and report of case. J Am Dent Assoc 94:548–550

    Google Scholar 

  29. Sinberg SE, Burman MS (1945) Roentgenologic visualization of the fractured temporal styloid process. Radiology 45:599–602

    Google Scholar 

  30. Sivers JE, Johnson GK, Lincoln MS (1985) Diagnosis of Eagle’s syndrome. Oral Surg Oral Med Oral Pathol 59:575–577

    PubMed  Article  CAS  Google Scholar 

  31. Smith RG, Cherry JE (1988) Traumatic Eagle’s syndrome: report of a case and review of the literature. J Oral Maxillofac Surg 46:606

    PubMed  Article  CAS  Google Scholar 

  32. Steinmann EP (1970) A new light on the pathogenesis of the styloid syndrome. Arch Otolaryngol 91:171–174

    PubMed  CAS  Google Scholar 

  33. Strauss M, Zohar Y, Laurian N (1985) Elongated styloid process syndrome: intraoral versus external approach for styloid surgery. Laryngoscopy 95:976

    CAS  Google Scholar 

Download references

Author information

Affiliations

  1. Av. Raja Gabaglia, 1000/1209—Gutierrez, Belo Horizonte, Minas Gerais, 30380-090, Brazil

    Bruno Ramos Chrcanovic

  2. Departamento de Odontologia, Pontifícia Universidade Católica de Minas Gerais, Av. Dom José Gaspar, 500 Prédio 45—Coração Eucarístico, 30535-610, Belo Horizonte, Minas Gerais, Brazil

    Antônio Luís Neto Custódio

  3. Av. do Contorno 4747/702—Funcionários, Belo Horizonte, Minas Gerais, 30110-921, Brazil

    Davidson Rodarte Felix de Oliveira

  4. Oral and Maxillofacial Surgery Department, School of Dentistry, Pontifícia Universidade Católica De Minas Gerais, Belo Horizonte, Brazil

    Antônio Luís Neto Custódio

  5. Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil

    Antônio Luís Neto Custódio

Authors
  1. Bruno Ramos Chrcanovic
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Antônio Luís Neto Custódio
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Davidson Rodarte Felix de Oliveira
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Bruno Ramos Chrcanovic.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Chrcanovic, B.R., Custódio, A.L.N. & de Oliveira, D.R.F. An intraoral surgical approach to the styloid process in Eagle’s syndrome. Oral Maxillofac Surg 13, 145–151 (2009). https://doi.org/10.1007/s10006-009-0164-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10006-009-0164-6

Keywords

  • Eagle’s syndrome
  • Styloid process
  • Stylohyoid ligament
  • Ossification