INTRODUCTION
Eagle’s Syndrome is characterized by a specific orofacial secondary to calcification of the stylohyoid ligament or elongated styloid process.
- AKA Styloid syndrome/ Styloid chain ossification.
- Ossification of the styloid ligament usually extends downwards from the base of skull and commonly occurs bilaterally.
- Ossification begins at the lesser horn of the hyoid or in the central area of ligament.
Distribution
- About 4% of general population have elongated styloid process; while only about 4% of these are symptomatic.
- Styloid process is considered abnormal if it is greater than 25 cm in length.
CLINICAL FEATURES
- Sensation of foreign body in throat (Tonsillar fossa)
- Constant dull naing ache in throat
- Dysphagia
- Pain is usually worse with swallowing
- Pain upon head movement/ Mouth opening/ Yawning
- Otalgia (pain radiating to ear)
- Tinnitis
- Temporal Headache
- Facial Pain or Headache
- Carotodynia (pain in direction of carotid arteries)
- TMJ pain
- Glossopharyngeal Neuralgia
- Bony Projection is usually Palpable with bimanual transoral exploration
CLINICAL EXAMINATION
Basically, you put your finger in mouth of the patient; down their throat and push towards the outside where stylohyoid bone is; if this reproduces pain -> this confirms the diagnosis.
RADIOGRAPHIC EXAMINATION
Lateral radiograph and CT of head and neck -> Elongated styloid process of at least 25 cm.
DIFFERENTIAL DIAGNOSIS
- TMJ Dysfunction (No radio-graphic evidence of ligament ossification)
MANAGEMENT
- Medical Treatment represents the 1st choice : NSAIDS
- Local Treatment : Corticoid Injection
- If not effective : Amputation of Stylohyoid process
- In case of persistance/ ingravescence of complaint, surgery may be the only option.
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