Eagle syndrome

Raina, Deepika; Gothi, Rajesh; Rajan, Sriram

doi:10.4103/0971-3026.50826

Cited by 43 publications

(37 citation statements)

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“…Pain is a variable feature and may be referred anywhere from the ipsilateral parietal bone to the pectoral region of the chest [3,19,33,40,49,51,60,64,66,70]. This pain is usually dull, constant, and nagging and is often aggravated by swallowing and yawning [50,68,84]. Inspiratory and expiratory stridor is rare and is typically only seen in children when the airway is already narrow [16,34,85].…”

Section: Clinical Featuresmentioning

confidence: 99%

Eagle’s syndrome: embryology, anatomy, and clinical management

2012

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Background Eagle's syndrome refers to a rare constellation of neuropathic and vascular occlusive symptoms caused by pathologic elongation or angulation of the styloid process and styloid chain. First described in 1652 by Italian surgeon Piertro Marchetti, the clinical syndrome was definitively outlined by Watt Eagle in the late 1940s and early 1950s. Methods This article reviews how underlying embryologic and anatomic pathology predicts clinical symptomatology, diagnosis, and ultimately treatment of the syndrome. Results The length and direction of the styloid process and styloid chain are highly variable. This variability leads to a wide range of relationships between the chain and the neurovascular elements of the neck, including cranial nerves 5, 7, 9, and 10 and the internal carotid artery. In the classic type of Eagle's syndrome, compressive cranial neuropathy most commonly leads to the sensation of a foreign body in the throat, odynophagia, and dysphagia. In the carotid type, compression over the internal carotid artery can cause pain in the parietal region of the skull or in the superior periorbital region, among other symptoms. Conclusions Careful recording of the history of the present illness and review of systems is crucial to the diagnosis of Eagle's syndrome. After the clinical examination, the optimal imaging modality for styloid process pathology is spiral CT of the neck and skull base. Surgical interventions are considered only after noninvasive therapies have failed, the two most common being intraoral and external resection of the styloid process. Embryology and phylogenyThe embryologic history of the styloid process, stylohyoid ligament, and hyoid bone is a subject of debate. Revilla and Stuyt [69] suggest that the styloid process, stylohyoid ligament, and lesser cornu of the hyoid bone develop from endochondral ossification of Reichert's cartilage, the cartilaginous component of the second branchial arch. They assert that after 3 months of fetal life, Reichert's cartilage is disrupted and divided into five distinct components (from proximal to distal): tympanohyal, stylohyal, ceratohyal, hypohyal, and basyhyal [58,69]. The tympanohyal component contributes to the tympanic bone and the base of the styloid process. The stylohyal component contributes to the majority of the styloid process, and the hypohyal and basyhyal components contribute to the hyoid bone. In many animals the ceratohyal component ultimately becomes the epihyoid bone. In humans, Revilla and Stuyt [69] contend that it degenerates to form the stylohyoid ligament.In contrast, during their detailed description of Reichert's cartilage in 50 human embryos and fetuses, RodriguezVazquez et al. [72] suggested that the second branchial arch cartilage is formed in two distinct segments separated by mesenchymal tissue. The proximal and larger segment is continuous with the otic capsule and becomes the styloid process. The smaller and more distal component forms the

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Section: Clinical Featuresmentioning

confidence: 99%

Eagle’s syndrome: embryology, anatomy, and clinical management

2012

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“…It can be idiopathic, congenital (due to persistence of cartilage elements of the precursors of the styloid process) or acquired 3 .…”

Section: Discussionmentioning

confidence: 99%

Eagle's syndrome

Soldati

Miguelote

Quero³

et al. 2013

Arq. Neuro-Psiquiatr.

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Eagle's syndrome (ES) consists of craniofacial and neck pain due to elongation of the styloid process and/or calcification of the stylohyoid ligament 1 . The normal length of the styloid process ranges from 2 to 3 cm and it is hardly palpable. ES is usually an asymptomatic disease that mostly affects women aged 30 to 50 years.According to Eagle, two types of the syndrome have been described 2 : (A) the classic syndrome characterized by pain in the tonsillar fossa, sometimes associated with dysphagia and hypersalivation, and often followed by tonsillectomy and (B) the styloid-carotid syndrome: the styloid process compresses the carotid arteries and exerts particular pressure on its sympathetic fibers. This subtype is not correlated with tonsillectomy.We report the case of a young patient with ES and a styloid process of normal lenght, but with significant ligament calcification. CASEA 20-year-old female patient presented at the Neurology Service with a continuous, daily, pressure-type pain on the left side of the neck radiating to frontal and temporal regions.

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“…The development of threedimensional CT (3D CT) has made it easier to delineate the anatomy of the surrounding structures. 3D CT is of great help when surgical correction is planned [12].…”

Section: Discussionmentioning

confidence: 99%

Incidental Finding of an Elongated Styloid Process during Tonsillectomy Procedure

Alekri¹,

Alsaei²

2015

IJOHNS

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Patients with recurrent throat pain, dysphagia, or facial pain symptoms might have Eagle's syndrome due to abnormal length of the styloid process or calcification of stylohyoid ligament complex. In adults, the styloid process is approximately 2.5 cm long. The etiology of this disease is not well understood, and usually asymptomatic. In some cases, the styloid tip, which is located between the external and internal carotid arteries, compresses the perivascular sympathetic fibers, resulting in a persistent pain. The disease can be diagnosed by physical examination through digital palpation of the styloid process in the tonsillar fossa or by radiographic workup that includes anterior-posterior and lateral skull films. We report a 33-year-old woman with an incidental finding of an elongated styloid process during a routine tonsillectomy procedure.

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Eagle syndrome

Cited by 43 publications

References 0 publications

Eagle’s syndrome: embryology, anatomy, and clinical management

Eagle’s syndrome: embryology, anatomy, and clinical management

Eagle's syndrome

Incidental Finding of an Elongated Styloid Process during Tonsillectomy Procedure

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