A Rare Cause for Cervical Pain: Eagle's Syndrome

Abstract

Patients with pharyngodynia and neck pain symptoms can lead to an extensive differential diagnosis. Eagle's syndrome must be taken in account. Eagle defined “stylalgia” as an autonomous entity related to abnormal length of the styloid process or to mineralization of the stylohyoid ligament complex. The stylohyoid complex derives from Reichert's cartilage of the second branchial arch. The styloyd process is an elongated conical projection of the temporal bone that lies anteriorly to the mastoid process. The incidence of Eagle's syndrome varies among population. Usually asymptomatic, it occurs in adult patients. It is characterized by pharyngodynia localized in the tonsillar fossa and sometimes accompanied by disphagia, odynophagia, foreign body sensation, and temporary voice changes. In some cases, the stylohyoid apparatus compresses the internal and/or the external carotid arteries and their perivascular sympathetic fibers, resulting in a persistent pain irradiating in the carotid territory. The pathogenesis of the syndrome is still under discussion.

A rare case report of Eagle’s syndrome complicated with chronic mouth opening, its management and complete rehabilitation; dental perspective

“…Considering the patient age and health, the case was managed with bilateral styloidectomy using an intraoral tonsillar sparing approach (Complete Edentulism provides wide accessibility at the surgical site and is in favour of selecting this approach). 20,22 The procedure was easy to execute, time saving and with good specificity. The exposure was adequate and the amount of dissection required was minimal.…”

“…Custom designed instrument was not only effective in detaching styloid attachments, but also reduced chances of damage to nearby structures (like neurovascular damage, deep cervical infection, poor visualization of surgical field) to zero. 21,22 Same instrument was used to break the styloid process from its base. 19,20 The patient got immediate relief from pain symptoms due to removal of pressure on the adjacent vital structures.…”

“…20,21 Several pharmacological and conservative treatments are still being practiced like: analgesics and local corticosteroids or anesthetic administration (such as transpharyngeal anesthetics in the tonsillar fossa) has been suggested, but turned out to be non-effective. 6,22 Infiltration of local anesthetics can be used as a proof therapy to see if a patient's complaints are related to an elongated styloid process.…”

Роль Шило-Каротидного Синдрому В розвитку Дисекції Внутрішньої Сонної Артерії І Інфаркту Мозку (Огляд Літератури, Власне Спостереження)

“…Могут наблю-даться шум/звон в ухе, иррадиация боли в височную либо теменную область, глаз, нижнечелюстной сустав, область подъязычной кости, ухо. Кроме указанной сим-птоматики реже отмечаются гиперсаливация, дисфазия и изменение голоса, дисфагия (иногда преходящая), нарушение чувствительности и вкуса на задней трети языка [3,21,23,32]. Семиологию шилоподъязычного синдрома объясняют воздействием шиловидного ком-плекса либо спазмированной шилоглоточной мышцы на прилежащие каудальные ЧН.…”

Prise en charge chirurgicale par voie endobuccale d’une patiente atteinte d’un syndrome d’Eagle : cas clinique et revue de la littérature

“…Il est possible aussi que la longueur et l'angulation de la styloïde soient secondaires à des variations interindividuelles d'origine génétique [23]. L'élonga-tion pourrait provenir des séquences régulatrices des gènes participant à la migration de la crête neurale cervicale et donc des points d'insertion musculaires [1] ; -l'élongation à la jonction cartilagineuse du centre tympano-hyalin et du LSH par un défaut de l'ossification ; -l'association avec les dérèglements hormonaux provoqués par la ménopause [16] ; -la persistance d'éléments mésenchymateux susceptibles de produire du tissu osseux à l'âge adulte [28] ; -des dépôts de sels de calcium d'origine indéterminée pourraient aussi être à l'origine d'une ossification du LSH [9,29] Ainsi, pour Eagle [19], on trouverait, dans la population générale, 4 % de patients possédant une ESP, et, chez ces patients, 4 % seraient symptomatiques, soit 0,16 % de la population générale. Malgré leurs divergences sur la fréquence de la pathologie, les auteurs s'accordent à dire que : -la moyenne d'âge des patients varie autour de 40 ans et l'incidence augmente avec l'âge [6][7][8] ; -l'ESP est souvent bilatérale mais les symptômes sont géné-ralement unilatéraux [5,16] ; -on trouve généralement plus de femmes que d'hommes, avec une incidence très forte chez les femmes âgées [16].…”