Evaluation of the styloid process on digital panoramic radiographs

Abstract

Background:The styloid process is an anatomical structure, whose clinical importance is not well understood. Proper clinical and radiographic evaluation can detect an elongated styloid process and calcification of the stylohyoid ligament. It has been reported that 2 – 28% of the general population show radiographic evidence of mineralization of a portion of the stylohyoid chain. The elongated styloid process may be symptomatic in many cases. Panoramic radiography is the best imaging modality to view the styloid process bilaterally.Aim:To assess the styloid process on digital panoramic radiographs.Materials and Methods:The study was conducted on 500 digital panoramic radiographs available in the archives of our department as soft copies. These radiographs were taken using a digital panoramic system. The radiographic length of the styloid process was measured on both sides using the measurement toolbars on the accompanying analysis software. For statistical analysis we used the unpaired t test, Chi-square test, and one-way ANOVA test, as necessary.Results:The average length of the left styloid was 25.41 ± 6.32 mm and that of the right styloid was 25.53 ± 6.62 mm. The length of both styloids increased with age and males had longer styloids than females. Elongated styloids were present in 19.4% of the panoramic radiographs. Langlais type I elongated styloids and a partial calcification pattern were more common than others.Conclusion:Panoramic radiography is useful for detection of an elongated styloid process and / or ossification of the stylohyoid ligament in patients with or without symptoms, and helps avoid a misdiagnosis of tonsillar pain or pain of dental, pharyngeal, or muscular origin.

Prevalence and pattern of the elongated styloid process among geriatric patients in Saudi Arabia

“…In the present study, it was found that type I elongation was more common than other types of elongation on both right and left sides and the data were statistically significant; these observations were similar to the findings reported by few other studies 23,27,29…”

“…This finding was in accordance with Bozkir et al,19 Vadgaonkar et al,22 Roopashri et al23 and Shaik et al30 However, More and Aarani27 observed that the elongated styloid process was more common on the right side in their study population. Ilgüy et al6 and Custodio et al31 observed no difference in the length of the styloid process when the sides were compared.…”

“…In the present study, it was found that males had more elongated styloid processes than females, which was in accordance with More and Aarani 27. However, in the studies conducted by Roopashri et al,23 Phulambrikar et al24 and Ferrario et al,28 it was found that females had an elongated styloid process than males, but their data were not statistically significant.…”

Clinicoradiologic evaluation of styloid process calcification

“…We observed that the calcified styloid was more prevalent in older subjects, which was in accordance with the previous findings that with ageing there was progression in styloid process elongation 13. Additionally, we noted that the male population had a predilection for styloid process elongation.…”

“…A study was performed on the population of the Davangere region of Southern India16 where 173 panoramic radiographs were reviewed and the incidence of mineralization of the styloid process was found to be 24.8%. Also, More and Asrani studied 500 digital panoramic radiographs of a population in the Gujarat region of Western India, and they found elongated styloid process in 19.4% of its subjects 13. Both these investigators favored the theory of ageing for styloid process elongation.…”