Stylalgia - Glossopharyngeal Neuralgia: Outcome of Management

Abstract

Elongated styloid may pose either Classical Eagle's or Stylocarotid syndrome leading to oro-facial pain. However, in patients of oro-facial pain, the investigation about the elongation of styloid process (SP) is not made routinely. Consequently, SP elongation is usually over looked as possible cause of symptom referral. Materials and Methods:In our study the various presenting symptoms were throat pain, ipsilateral otalgia and foreign body sensation in throat. Digital palpation of styloid process and accentuation of pain in tonsillar fossa, positive lignocaine test along with radiological demonstration of the elongation of styloid process confirm the diagnosis. Total of 30 patients were treated surgically by transoral Styloidectomy for oro-facial pain. All resected tonsils were subjected to histopathological examination.

Eagle’s Syndrome Managed Successfully by Pulsed Radiofrequency Treatment

“…The incidence of elongated styloid process is 4% in the general population, of which only 4% are reported to be symptomatic, with a female-to-male ratio of 3:1. It is usually reported in adults after the third decade of life [4].…”

“…In the general population, the length of the styloid process is usually less than 2.5 cm. It is interpreted as elongated when the length is more than 3-4 cm (as seen in imaging studies), and it includes the combined length of the styloid process and the ossified stylohyoid ligament [4]. There are several hypotheses regarding the pathogenesis of Eagle's syndrome.…”

“…Treatment of Eagle's syndrome usually begins with pharmacological agents such as anticonvulsants, antidepressants, non-steroidal anti-inflammatory drugs (NSAIDs), acetaminophen, and weak opioids such as tramadol. Surgical intervention in the form of styloidectomy is the definitive management when medical management fails [4]. Moreover, minimally invasive interventional therapy in the form of glossopharyngeal nerve block followed by radiofrequency treatment is an attractive alternative.…”