TMSS Medical College Journal

Abstract Eagle’s Syndrome, sometimes called as Styloid or Stylohyoid Syndrome, is a symptom complex associated with the elongation of the styloid process or ossification of stylohyoid ligament, clinically characterized by dull and nagging pain in the throat and neck that becomes worse during deglutition and can be reproduced by palpation of the tonsillar fossa. Eagle’s Syndrome represents clinical characteristics as non-specific orofacial pain, unilateral, not responsive to painkillers and mostly in adult women. The diagnosis must be made through a detailed history, clinical examination and various imaging modalities (computed tomography with multiplane reconstruction and 3D volumetric reconstructions). This paper discussed a case of lower left facial pain for about 6 months, in a 40 years old, female patient who was diagnosed as unilateral elongated styloid process.

The styloid process of the temporal bone is elongated, conical projection that lies anterior to the mastoid process of temporal bone in the neck between the internal and external carotid arteries and is lateral to the tonsillar fossa.! Watt Weems Eagle, 1937, an American Otolaryngologist, was the first person to describe Eagle’s syndrome (ES) or Stylohyoid Syndrome as an abnormally long styloid process or styloid chain ossification producing cluster of symptoms, characterized by craniofacial or cervical pain.2*** The normal styloid process is approximately 2.5-3.0cm in length.* An elongated styloid process is incidental in about 4% of the general population, but of these, only about 4% present with symptoms that areattributable to elongation of styloid; therefore, the true incidence is about 0.16%, with a female-to-male predominance of 3:1. Patients are usually greater than 30 years of age, and this is usually a bilateral process (although unilateral cases are also seen). The syndrome is usually reported in adults after third decade of life with a female to male ratio of 3:1. Patient with ES may present with wide variety of symptoms including dull, aching pain on either side of the throat, difficult in swallowing, foreign body sensation in the throat, pain in facial region, cervical pain, otalgia, cervico-facial pain, recurrent headache,  vertigo.” However, the characteristic dull and nagging pain that becomes worsen during deglutition and can be reproduced by palpation of the tonsillar fossa is the hallmark. Since these symptoms mimic many maxillofacial and oropharyngeal disorders and neuralgias, a thorough clinical history, examination, and radiological assessment are necessary for attaining a diagnosis. Here, we present one such case of Eagle’s syndrome in a female patient, explain the diagnosis and mentioned plan of management.