Background: In the present article we present the characteristics of Eagle syndrome, which is an often overlooked cause of chronic pain in the neck and head. The syndrome is caused by the compression of an elongated styloid process on the adjacent cranial nerves or the carotid arteries. Since there are disparate data in the literature regarding the proportion of people with an elongated styloid process, we conducted a survey to determine the percentage of patients with an elongated styloid process in a group of subjects who underwent computed tomographic imaging of the neck vessels in our institution.Methods: We analyzed the images of 104 patients who were referred to our institution for computed tomographic angiography of the neck between the years 2014 and 2016. With the help of a software measurement tool, we determined the length of the styloid processes and compared the length of the processes on both sides and in both genders. Patients with an elongated styloid process were reviewed for any symptoms of Eagle syndrome.Results: The average age of the reviewed patients was 67.1 years. Both genders were equally represented (51 % men and 49 % women). The average length of the styloid process was 23.8 (7.0) mm, with 23 patients (22.1 %) having a styloid process longer than 30 mm. In one third of those patients the styloid process was elongated bilaterally. There were no differences in the average length of the styloid process between men and women and between the left and the right side. Among patients with an elongated styloid process, only one (4.3 %) had symptoms attributable to the Eagle syndrome.Conclusions: Eagle syndrome should be suspected in a patient with repetitive, dull pain in the throat and neck, which worsens during speaking, chewing or swallowing. The diagnosis is confirmed by computed tomography which could demonstrate an elongated styloid process and exclude other causes for neck pain. With regard to the results of our study, an elongated styloid process is found in a relatively high percentage of patients but the condition is only rarely symptomatic.
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