Skip to main content
SpringerLink
Log in

The distribution of stylohyoid chain anatomic variations by age groups and gender: an analysis using MDCT

  • Head and Neck
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

The aim of this study is to investigate the frequency of the SHC variations, and the distribution of the SP lengths in different age and sex groups using MDCT. MDCT scans were performed in 805 patients (401 males, 404 females). The patients were divided into six groups according to their ages. The length of the styloid process (SP) and its angulation on the transverse (TA) and sagittal (SA) planes were measured. Structural variations of the SHC were observed by means of three-dimensional (3D) and multiplanar reconstruction (MPR) images. Absence of the styloid process (n = 10), double proximal origin (n = 13), segmentation (n = 223), complete ossification (n = 24), and an SP with three proximal parts in one patient were among the anomalies detected. The mean length of the SP was greater in males than in females (33.2 ± 13.2 vs. 29.6 ± 10.5 mm, P < 0.001). Elongated SP (ESP) was observed in 56 % of the patients in the study group, and this ratio was the highest in Group 3 with 65.4 % (P < 0.05). TA and SA were 70.2° ± 4.1°, 69.9° ± 4.2° and 86.6° ± 6.5°, 88.3° ± 6.6° for the right and left sides, respectively. Besides, 3D and MPR images also present detailed and reliable data to radiologists and surgeons for the evaluation of the SHC. ESP has been detected in more than half of the patients, being more frequent in males and in individuals in the fifth decade of life. For an accurate diagnosis, clinicians should consider the ESP while evaluating the patients in this age group.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

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

Similar content being viewed by others

References

  1. O’Carroll MK (1984) Calcification in the stylohyoid ligament. Oral Surg Oral Med Oral Pathol 58:617–621

    Article  Google Scholar 

  2. Onbaş O, Kantarcı M, Karasen RM et al (2005) Angulation, length, and morphology of the styloid process o the temporal bone analyzed by multidetector computed tomography. Acta Radiol 8:881–886

    Article  Google Scholar 

  3. Ramadan SU, Gökharman D, Koşar P et al (2010) The stylohyoid chain: CT imaging. Eur J Radiol 75:346–351

    Article  PubMed  Google Scholar 

  4. Basekim C, Mutlu H, Gungor A et al (2005) Evaluation of styloid process by three dimensional computed tomography. Eur Radiol 15:134–139

    Article  PubMed  Google Scholar 

  5. Gözil R, Yener N, Çalgüner E, Araç M, Tunç E, Çelioflu M (2001) Morphological characteristics of styloid process evaluated by computerized axial tomography. Ann Anat 183:527–535

    Article  PubMed  Google Scholar 

  6. Ramadan SU, Gökharman D, Tunçbilek I, Kacar M, Koşar P, Koşar U (2007) Assessment of the stylohyoid chain by 3D-CT. Surg Radiol Anat 29:583–588

    Article  PubMed  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  8. Ceylan A, Köybaşioğlu A, Celenk F, Yilmaz O, Uslu S (2008) Surgical treatment of elongated styloid process: experience of 61 cases. Skull Base 18:289–295

    Article  PubMed  Google Scholar 

  9. Yavuz H, Caylakli F, Yildirim T, Ozluoglu LN (2008) Angulation of the styloid process in Eagle’s syndrome. Eur Arch Otorhinolaryngol 265:1393–1396

    Article  PubMed  Google Scholar 

  10. Ghosh LM, Dubey SP (1999) The syndrome of elongated styloid process. Auris Nasus Larynx 26:169–175

    Article  PubMed  CAS  Google Scholar 

  11. Jung T, Tschernitschek H, Hippen H, Schneider B, Borchers L (2004) Elongated styloid process: when is it really elongated? Dentomaxillofac Radiol 33:119–124

    Article  PubMed  CAS  Google Scholar 

  12. Palesy P, Murray GM, De Boever J, Klineberg I (2000) The involvement of the styloid process in head and neck pain: a preliminary study. J Oral Rehabil 27:275–287

    Article  PubMed  CAS  Google Scholar 

  13. Rath G, Anand C (1991) Abnormal styloid process in a human skull. Surg Radiol Anat 13:227–229

    Article  PubMed  CAS  Google Scholar 

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

    Article  PubMed  Google Scholar 

  15. Prasad KC, Kamath MP, Reddy KJM, Raju K, Agarwal S (2002) Elongated styloid process (Eagle’s Syndrome): a clinical study. J Oral Maxillofac Surg 60:171–175

    Article  PubMed  Google Scholar 

  16. Satyapal KS, Kalideen JM (2000) Bilateral styloid chain ossification: case report. Surg Radiol Anat 22:211–212

    Article  PubMed  CAS  Google Scholar 

  17. Eagle W (1937) Elongated styloid process: report of two cases. Arch Otolaryngol 25:584–586

    Article  Google Scholar 

  18. Ferrario VF, Sigurta D, Daddona A et al (1990) Calcification of the stylohyoid ligament: incidence and morphoquantitative evaluations. Oral Surg Oral Med Oral Pathol 6:524–529

    Article  Google Scholar 

  19. Savranlar A, Uzun L, Ugur MB, Ozer T (2005) Three-dimensional CT of Eagle’s syndrome. Diagn Interv Radiol 11:206–209

    PubMed  Google Scholar 

  20. Baugh RF, Stocks RM (1993) Eagle’s syndrome: a reappraisal. Ear Nose Throat J 72:341–344

    PubMed  CAS  Google Scholar 

  21. Fini G, Gasparini G, Filippini F, Becelli R, Marcotullio D (2008) The long styloid process syndrome or Eagle’s syndrome. J Craniomaxillofac Surg 28:123–127

    Article  Google Scholar 

  22. Strauss M, Zohar Y, Laurian N (1979) Elongated styloid process syndrome: intraoral versus external approach for styloid surgery. Laryngoscope 95:976–979

    Google Scholar 

  23. Chase DC, Zarmen A, Bigelow WC, McCoy JM (1986) Eagle’s syndrome: a comparison of intraoral versus extraoral surgical approaches. Oral Surg Oral Med Oral Path 62:625–629

    Article  PubMed  CAS  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Radiology, School of Medicine, Dicle University, 21280, Diyarbakir, Turkey

    Faysal Ekici, Guven Tekbas, Cihad Hamidi, Hakan Onder, Cemil Goya, Mehmet Guli Cetincakmak, Hatice Gumus, Aşur Uyar & Aslan Bilici

Authors
  1. Faysal Ekici
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Guven Tekbas
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Cihad Hamidi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hakan Onder
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Cemil Goya
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Mehmet Guli Cetincakmak
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hatice Gumus
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Aşur Uyar
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Aslan Bilici
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Faysal Ekici.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ekici, F., Tekbas, G., Hamidi, C. et al. The distribution of stylohyoid chain anatomic variations by age groups and gender: an analysis using MDCT. Eur Arch Otorhinolaryngol 270, 1715–1720 (2013). https://doi.org/10.1007/s00405-012-2202-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-012-2202-5

Keywords

Search

Navigation