Relationship of stylohyoid chain and cervical internal carotid artery detected by 3D angiography

Eraslan, Cenk; Özer, Mehmet Asım; Gövsa, Figen; Alagoz, Ahmet Kemal; Çallı, Cem

doi:10.1007/s00276-017-1812-4

Cited by 12 publications

(12 citation statements)

References 31 publications

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“…Located between the ICA and the external carotid artery, the distal end of the SP extends inwards, forwards, and downwards (10,11). As shown in our current study, ultrasound could clearly reveal the positional relationship between the SP and blood vessels in the neck.…”

Section: Discussionsupporting

confidence: 70%

The anatomic basis for ultrasound in the diagnosis and treatment of styloid process–related diseases

et al. 2020

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Background: The styloid process (SP), stylohyoid ligament and lesser horn of hyoid bone together form the stylohyoid chain. Differences in the ossification degree and the connection sites of each segment of the stylohyoid chain on both sides lead to variations in the length, orientation, thickness, and straightness of SP. The incidence of elongation of the SP, known as styloid process syndrome (SPS), is around 4%, with only 4% of patients showing elongation show symptoms. Computed tomography (CT) remains the firstchoice auxiliary examination for diagnosing SPS, but its performance can be affected by a variety of factors.Ultrasound can reveal the parapharyngeal space and adjacent structures, which offer high consistency with CT findings. Here, we investigated the ultrasonographic features of the SP and its adjacent structures in normal adults and assessed the clinical utility of ultrasound assessment for SP-related diseases.Methods: With the ramus of mandible, mastoid process, SP, and salivary gland as the anatomical landmarks, ultrasonography was conducted on the parapharyngeal space in 78 healthy adults. The scans were performed along the oblique coronal section of the ramus and the cross-sectional plane between the mastoid process and ramus to visualize the SP and its adjacent structures. The SP length, the shortest distance from the SP tip to the outer edge of tonsil (SP-tonsil distance), and the distance from SP to the internal carotid artery (SP-ICA distance) were measured.Results: SP and its adjacent structures were successfully visualized on ultrasonography in all 78 subjects.The measured SP length was 2.65±0.48 cm. The SP-tonsil distance was 1.95±0.50 cm. The SP-ICA distance was 0.509±0.231 cm. The SP length and SP-tonsil distance measured by ultrasound were not significantly different from those measured by CT (P=0.071, P=0.053). Furthermore, the SP length and SP-tonsil distance measured by ultrasound were positively correlated with CT measurements (r=0.917, P=0.071; r=0.978, P=0.053, respectively). SP-tonsil distance was negatively correlated with SP length and SP inward deflection angle.Conclusions: Ultrasound can accurately reveal the shape and size of SP and its adjacent structures and thus will be helpful for the diagnosis of SP-related diseases.

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Section: Discussionsupporting

confidence: 70%

The anatomic basis for ultrasound in the diagnosis and treatment of styloid process–related diseases

et al. 2020

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“…Eagle defined a styloid process of 25 mm or longer as being elongated and reported an elongated styloid process was present in 4% of autopsies, among which 4% were symptomatic [ 2 ]. A recent study [ 3 ] reported that the frequency is higher than that reported by Eagle. Currently, many authors define a styloid process that is 30 mm or longer as being elongated [ 4 ].…”

Section: Discussionmentioning

confidence: 79%

“…Spontaneous fracture may occur due to swallowing, yawning, coughing, or sudden laughing [ 10 ]. The underlying causes of traumatic fracture are clear, while those of spontaneous fracture are not; therefore, patients may often be left undiagnosed and the symptoms may be interpreted as “symptoms of unknown cause” or “indefinite complaints.” Recently, many studies have used 3D-CT or 3D-CT angiography when an elongated styloid process is suspected [ 3 , 7 ]. The use of 3D-CT is recommended because it is better than panoramic X-ray in detecting minor fractures.…”

Section: Discussionmentioning

confidence: 99%

A Rare Case of Elongated Styloid Process Fracture

et al. 2020

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“…Finally, yet importantly, it is necessary to emphasize perhaps the most significant factor in the “rise of popularity” of Eagle´s syndrome—a newly described neurological symptomatology possibly associated with the elongated styloid process. It can be a causative factor in the development of internal carotid artery compression [ 2 ], significant compression of the internal jugular vein [ 14 , 15 ], stylocarotid syndrome due to mechanical irritation of the sympathetic plexus in the cervical internal carotid artery [ 16 ] or stroke due to carotid artery dissection [ 17 ]. These recently described neurological morbidities possibly caused by the elongated styloid process have a tendency to spark the interest of many other fellow scientists, a phenomenon known as the “snowball effect”—one study builds upon the previous one.…”

Section: Introductionmentioning

confidence: 99%

The Syndrome of Elongated Styloid Process, the Eagle’s Syndrome—From Anatomical, Evolutionary and Embryological Backgrounds to 3D Printing and Personalized Surgery Planning. Report of Five Cases

et al. 2020

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Background and Objectives: The symptoms of Eagle’s syndrome are associated with the elongated styloid process of the temporal bone or calcification of the stylohyoid ligament. The first mention of pain syndrome associated with the elongated styloid process dates back to 1937, when it was described by Watt Weems Eagle. Over the last decade, experts in the field have shown a lively interest in the issue of the relationship between the elongated styloid process and various symptoms. This article presents the correlation between the clinical signs of Eagle’s syndrome and alterations in surrounding anatomical structures. It includes a brief review of the evolutionary, embryological and clinical anatomical background of the elongated styloid process. Materials and Methods: Between 2018 and 2019, five patients were admitted to our workplace with 1–3-year history of bilateral or unilateral throat pain, otalgia and pharyngeal foreign body sensation. As a therapeutic novelty in the surgical approach to this condition, we used individual 3D printed models to measure and identify the exact location of the resection of the styloid process without damaging the surrounding anatomical structures, such as the facial, accessory, hypoglossal, and vagal nerves; the internal jugular vein; and the internal carotid artery. Results: Compared to traditional surgical methods without 3D models, 3D models helped to better identify cutting edges and major landmarks used in surgical treatment of Eagle’s syndrome. Printed models provided assistance with the exact location of the styloid process resection position without damaging the surrounding anatomical structures such as the facial, accessory, hypoglossal, and vagal nerves; the internal jugular vein; and the internal carotid artery. Conclusion: In our clinical report, we used 3D printed models for navigation and planning during surgical procedures involving resections of the elongated styloid process. Additionally, we can formulate a new hypothesis: the elongated styloid process is a form of atavism of the bony hyoid apparatus in our evolutionary ancestors that is evolutionarily encoded or arises from disrupted degeneration of the middle portion of embryonal Reichert´s cartilage of the second pharyngeal arch. Under normal conditions, this portion does not ossify but degenerates and transforms into a connective tissue band, the future stylohyoid ligament.

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Relationship of stylohyoid chain and cervical internal carotid artery detected by 3D angiography

Cited by 12 publications

References 31 publications

The anatomic basis for ultrasound in the diagnosis and treatment of styloid process–related diseases

The anatomic basis for ultrasound in the diagnosis and treatment of styloid process–related diseases

A Rare Case of Elongated Styloid Process Fracture

The Syndrome of Elongated Styloid Process, the Eagle’s Syndrome—From Anatomical, Evolutionary and Embryological Backgrounds to 3D Printing and Personalized Surgery Planning. Report of Five Cases

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