Tonsillostyloidectomy for Eagle’s syndrome: a study of 20 cases

Abstract

<p class="abstract"><strong>Background:</strong> Eagle’s syndrome is a pain syndrome which occurs due to elongated and misdirected styloid process. It is commoner than generally thought.</p><p class="abstract"><strong>Methods:</strong> 20 cases of styalgia were diagnosed and prospectively studied at two hospitals. The characteristic symptoms were chronic throat pain and foreign body sensation in throat. Diagnosis was made with clinical symptoms, physical examination in form of intraoral palpation of styloid and radiological correlation. All patients underwent Tonsillostyloidectomy for affected sites under General anaesthesia. The patients were followed up for 12 weeks post-operatively and relief of symptoms was noted. </p><p class="abstract"><strong>Results:</strong> Chronic throat pain was the commonest symptom. Most cases were associated with chronic tonsillitis or Laryngopharyngeal reflux disease (LPRD). 19 (95%) patients were symptom free by 4 weeks postoperatively.</p><strong>Conclusions:</strong> In an established case of Styalgia with intraoral palpable styloid tip, tonsillostyloidectomy by intra-oral approach gives good results. Also, LPRD may be a possible aetiology of the disease. Incidentally, it was found that position of head over neck should be intraoperatively adjusted in order to suit easy approach to the styloid depending on antero-posterior angulation of styloid.

The incidence of elongated styloid process in chronic tonsillitis

“…Singh et al have shown in their study that 60% of their study population who had elongated styloid process presented with chronic tonsillitis. 4 Naik et al observed in their study that elongated styloid process and chronic tonsillitis were co-existent in all their cases. 5 In our study out of 160 chronic tonsillitis patients 119 had elongated styloid process which accounts to 73.4%.…”

Eagle syndrome presenting as anterior ischaemic neuropathy: a multidisciplinary approach

“…Eagle syndrome as first described by Watt Eagle in 1937 is a pain syndrome due to local neurovascular impinging caused by a styloid process elongation 1. The incidence of elongated styloid process can be up to 7%, but only a small percentage of this group (5%–10%) is symptomatic 2 3. Most patients will have the classic syndrome of neck pain and dysphagia, caused by compression on the glossopharyngeal nerve, and only a few patients will have carotid artery involvement.…”

“…The classic form of presentation, also known as stylohyoid syndrome, is caused by compression of cranial nerves V, VII, IX, X and their branches coursing through parapharyngeal space, and results in pain in the anterolateral neck with referred pain to the ear, foreign body sensation in the throat and dysphagia 1–3. Pain can be triggered by chewing, swallowing or turning of the head.…”