Outcomes of Elongated Styloid Process Syndrome Treated with Minimally Invasive Cervical Styloidectomy (MICS)—A Single-Center Retrospective Study

Abstract

Background: Stylohyoid syndrome, also known as classical Eagle syndrome (ES), is a rare condition characterized by elongation of the styloid process (SP) or calcification of the stylohyoid chain, presenting numerous non-specific symptoms. Most papers concerning this rare condition are case reports, case studies, or retrospective studies. This retrospective study delves into the intricacies of Eagle syndrome and evaluates surgical outcomes in patients treated with minimally invasive cervical styloidectomy (MICS). Methods: We conducted a retrospective study of patients treated due to ES between September 2021 and August 2023. Ninety-seven patients were qualified for MICS. Evaluation before and after surgical treatment was conducted during follow-up visits and by a questionnaire that included various data, such as symptoms, pain intensity, evaluation of healing period, and overall patient satisfaction. The minimum follow-up period was six months. Results: After applying inclusion and exclusion criteria, eighty-four patients were qualified for further assessment. The most common symptoms that subsided completely after treatment were pharyngeal foreign body sensation and pain with dysphagia or odynophagia. The MICS procedure proved to be highly effective, with 94.2% of patients experiencing a significant reduction in pain intensity and 97.1% reporting overall success. All patients were satisfied with the aesthetic outcome of the scar. The length of SP and time onset from the first symptoms to treatment positively correlated with the number, intensity, and time required for symptoms to subside. Conclusions: Eagle syndrome should be considered in diagnosing patients with orofacial and cervical pain symptoms, as the time from occurrence of the first symptoms to treatment is crucial. MICS is highly effective and has a low rate of complications in treating ES. Potential scar formation should not be a significant factor when deciding between the intraoral and external approaches.