Síndrome de Eagle com remoção cirúrgica do processo estiloide calcificado: Relato de caso clínico

Abstract

A síndrome de Eagle é uma condição clinica associada a um processo estiloide aumentado, com mais de 25mm de comprimento, o que gera uma compressão de estruturas anatômicas importantes provocando sintomas como dor cervical, dor facial, disfagia, otalgia, limitação de abertura bucal e outros. Por se tratar de uma síndrome rara com sintomas semelhantes a outras condições patológicas, é importante a realização do correto diagnóstico e tratamento. Seu tratamento pode ser conservador ou cirúrgico pela abordagem intra ou extra-oral. Este estudo trata-se de um relato de caso clinico, de um paciente 40 anos de idade, do gênero masculino, diagnosticado com síndrome de Eagle após apresentar sintomatologia dolorosa à abertura de boca, disfagia e otalgia e exame tomográfico evidenciar o processo estiloide com 30mm de comprimento. O tratamento de escolha foi a excisão cirúrgica do processo estiloide através da abordagem extra-oral, garantindo maior controle dos grandes vasos, melhor exposição e menor risco de contaminação bacteriana dos espaços cervicais profundos. Como resultado, o tratamento de escolha foi bem sucedido, com regressão total da sintomatologia, sem complicações.

Prevalence and characterization of the elongated styloid process in a population of southern Brazil

“…The styloid process is a thin bone projection that measures approximately 25 mm in length, originating in the temporal bone, anterior and medially to the stylomastoid foramen, from where the facial nerve arises (BRUNO et al, 2022;CAVALCANTE et al, 2017;GUIMARÃES et al, 2010;HANDEM et al, 2016;LINDENBLATT et al, 2018;Martello et al, 2019;Millán et al, 2019;NUNES et al, 2021;ÖZTAS;ORHAN;2012;PEREIRA et al, 2022;PIGACHE et al, 2018;RAFARE;CHAGAS;SAMPAIO et al, 2021). Amid this process are still located important structures such as the internal jugular vein, external and internal carotid artery, and the vagus, glossopharyngeal, accessory, and hypoglossal nerves (BALDINO et al, 2020;MUÑOZ-LEIJA et al, 2020;NUNES et al, 2021;PEREIRA et al, 2022;SAMPAIO et al, 2021;SOUZA et al, 2020).…”

“…Several studies state that when the styloid process has a length above 25 mm, it can be considered elongated (BORGES et al, 2021;CAVALCANTE et al, 2017;JALISI;JAMAL;GRILLONE;Millán et al, 2019;PEREIRA et al, 2022;SAMPAIO et al, 2021).…”

“…The cause of its elongation is not yet clearly described in the literature (BADHEY et al, 2017;BEDI et al, 2019; MAHMOUD; ASHOUR; 2020; Martello et al, 2019;NUNES et al, 2021; Prevalence and characterization of the elongated styloid process in a population of southern Brazil CHAPTER SAMPAIO et al, 2021;WATERS et al, 2019), but studies state that its incidence has been observed between 1.4% and 30% of the population, being more frequent in individuals over 30 years of age and occurring more frequently in women than in men, presenting a ratio of 3:1 (BADHEY et al, 2017;BEDI et al, 2019;JALISI;JAMAL;GRILLONE;MAHMOUD;ASHOUR;Martello et al, 2019;SAMPAIO et al, 2021;WATERS et al, 2019).…”

“…The elongation of the styloid process can occur asymptomatically, but when there are symptoms, these present in the most varied ways such as orofacial pain, headache, dysphagia, odynophagia, dysphonia, otalgia, limitation of the mouth opening, limitation of cervical movements and foreign body sensation in the throat (BARDHOSHI et al, 2022;HANDEM et al, 2016;JALISI;JAMAL;GRILLONE;LINDENBLATT et al, 2018;MAHMOUD;ASHOUR;Martello et al, 2019;SACCOMANNO et al, 2018;SAMPAIO et al, 2021;WESTBROOK;KABBAZ;SHOWALTER;.…”

“…There are also reports in the literature of the occurrence of reversible transient ischemic attacks, with the presence of ophthalmic symptoms and episodes of presyncope due to compression of the carotid artery, as well as decreased blood flow in the middle cerebral artery caused by the elongation of the styloid process (JALISI; JAMAL; GRILLONE; 2017; MAHMOUD; ASHOUR; 2020; SAMPAIO et al, 2021;YOKOYA et al, 2021). Borges et al (2021) state that even in the absence of symptomatology reported by the patient, it is also important to diagnose cases in which stretching of the styloid process is observed, since in the future these individuals have greater chances of presenting them.…”