Eagle's Syndrome

Abstract

Summary Introduction: Eagle's syndrome is characterized by cervicopharyngeal signs and symptoms associated with elongation of the styloid apophysis. This elongation may occur through ossification of the stylohyoid ligament, or through growth of the apophysis due to osteogenesis triggered by a factor such as trauma. Elongation of the styloid apophysis may give rise to intense facial pain, headache, dysphagia, otalgia, buzzing sensations, and trismus. Precise diagnosis of the syndrome is difficult, and it is generally confounded by other manifestations of cervicopharyngeal pain. Objective: To describe a case of Eagle's syndrome. Case Report: A 53-year-old man reported lateral pain in his neck that had been present for 30 years. Computed tomography (CT) of the neck showed elongation and ossification of the styloid processes of the temporal bone, which was compatible with Eagle's syndrome. Surgery was performed for bilateral resection of the stylohyoid ligament by using a transoral and endoscopic access route. The patient continued to present pain laterally in the neck, predominantly on his left side. CT was performed again, which showed elongation of the styloid processes. The patient then underwent lateral cervicotomy with resection of the stylohyoid process, which partially resolved his painful condition. Final Comments: Patients with Eagle's syndrome generally have a history of chronic pain. Appropriate knowledge of this disease is necessary for adequate treatment to be provided. The importance of diagnosing this uncommon and often unsuspected disease should be emphasized, given that correct clinical-surgical treatment is frequently delayed. The diagnosis of Eagle's syndrome is clinical and radiographic, and the definitive treatment in cases of difficult-to-control pain is surgical.

Telemedicine for a Multidisciplinary Assessment of Orofacial Pain in a Patient Affected by Eagle’s Syndrome: A Clinical Case Report

“…For the complex case of the patient reported in this article, telemedicine represented an optimal option to obtain an interdisciplinary assessment, also given the unusual circumstances. The intense facial pain, which is a characteristic of Eagle's syndrome [8], and the additional issues that arise, need to be evaluated by different experts, but often the consultations are serial, without much exchange of information between specialists, skewing the process in favor of more testing and less in favor of treatment and long term stability. Therefore, during the online meeting, some strategies and exercises were proposed to the patient to do before and after any possible maxillofacial surgery to improve her situation and, consequently, her quality of life.…”

“…The elongation of the styloid apophysis or the calcification of the stylohyoid ligament may give rise to intense facial pain, headache, dysphagia or odynophagia, otalgia, buzzing sensations, and trismus [8]. This elongation and calcification may influence the surrounding structures and cause a compression of the nerves and lymphatic and blood vessels [38,39].…”

“…Intraoral pain with a non-odontogenic cause can possibly be associated with trigeminal neuropathic pain or soft tissue pathologies [2]. Facial pain with or without intraoral involvement can be related to temporomandibular dysfunction [4,5], Trigeminal Neuralgia (TN) [6,7], Eagle's syndrome [8], headache-related facial pain and migraine (including neurovascular orofacial pain) [2]. Facial pain requires a multidisciplinary approach that, unfortunately, cannot always be achieved due to the difficulty in finding a facility where all specialists are present and work in teams.…”

The role of the styloid apophysis of the temporal bone in the biomechanics of the tongue, mandible, hyoid system: a case study

“…To date, computed tomography is considered to be the best examination for defining the length of the styloid process. 21 . In this case study, we outlined the complexity of the muscles that connect to the tongue, jaw and hyoid bone and then described the temporal-mandible-tongue-hyoid (THTH) system.…”

Fractured styloid process masquerading as neck pain: Cone-beam computed tomography investigation and review of the literature

“… 10 11 12 The differential diagnosis for a patient presenting with a fractured styloid process may include temporomandibular joint dysfunction, tonsillitis, pharyngitis, mastoiditis, pain secondary to unerupted or impacted third molars, glossopharyngeal neuralgia, sphenopalatine neuralgia, trigeminal neuralgia, pharyngeal foreign body or tumor, migraine, degenerative disc disease, chronic laryngopharyngeal reflux, cluster headache, or myofascial pain dysfunction syndrome. 15 19 20 21…”