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http://dx.doi.org/10.5624/isd.2018.48.1.67

Fractured styloid process masquerading as neck pain: Cone-beam computed tomography investigation and review of the literature  

Khan, Hassan M. (Division of Radiology, Department of Oral Medicine, University of Pennsylvania School of Dental Medicine)
Fraser, Andrew D. (Division of Growth and Development, Section of Orthodontics, School of Dentistry, University of California)
Daws, Steven (Division of Radiology, Department of Oral Medicine, University of Pennsylvania School of Dental Medicine)
Thoppay, Jaisri (Department of Oral and Maxillofacial Surgery, School of Dentistry, Virginia Commonwealth University)
Mupparapu, Mel (Division of Radiology, Department of Oral Medicine, University of Pennsylvania School of Dental Medicine)
Publication Information
Imaging Science in Dentistry / v.48, no.1, 2018 , pp. 67-72 More about this Journal
Abstract
Historically, Eagle syndrome is a term that has been used to describe radiating pain in the orofacial region, foreign body sensation, and/or dysphagia due to a unilateral or bilateral elongated styloid process impinging upon the tonsillar region. Because elongated styloid processes-with or without associated Eagle syndrome-can present with various symptoms and radiographic findings, it can be challenging for healthcare practitioners to formulate an accurate diagnosis. Abnormal styloid anatomy can lead to a multitude of symptoms, including chronic orofacial/neck pain, thus masquerading as more commonly diagnosed conditions. In this report, we describe a patient who presented to our department with styloid process elongation and fracture. A careful history, physical examination, and a cone-beam computed tomography (CBCT) investigation led to the diagnosis. The patient was then referred for appropriate care. This case report demonstrates the utilization of CBCT in differentiating a fracture site from a pseudo-joint that might mimic a fracture.
Keywords
Cone-Beam Computed Tomography; Neck Pain;
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1 Eagle WW. Elongated styloid process: report of two cases. Arch Otolaryngol 1937; 25: 584-7.   DOI
2 Eagle WW. Elongated styloid process; symptoms and treatment. AMA Arch Otolaryngol 1958; 67: 172-6.   DOI
3 Balbuena L Jr, Hayes D, Ramirez SG, Johnson R. Eagle's syndrome (elongated styloid process). South Med J 1997; 90:331-4.   DOI
4 Langlais RP, Miles DA, Van Dis ML. Elongated and mineralized stylohyoid ligament complex: a proposed classification and report of a case of Eagle's syndrome. Oral Surg Oral Med Oral Pathol 1986; 61: 527-32.   DOI
5 Mendelsohn AH, Berke GS, Chhetri DK. Heterogeneity in the clinical presentation of Eagle's syndrome. Otolaryngol Head Neck Surg 2006; 134: 389-93.   DOI
6 Balasubramanian S. The ossification of styloid ligament and its relation to facial pain. Br Dent J 1964; 116: 108-11.
7 Khandelwal S, Hada YS, Harsh A. Eagle's syndrome - a case report and review of the literature. Saudi Dent J 2011; 23: 211-5.   DOI
8 Keur JJ, Campbell JP, McCarthy JF, Ralph WJ. The clinical significance of the elongated styloid process. Oral Surg Oral Med Oral Pathol 1986; 61: 399-404.   DOI
9 Tiwary P, Sahoo N, Thakral A, Ranjan U. Styloid process fracture associated with maxillofacial trauma: incidence, distribution, and management. J Oral Maxillofac Surg 2017; 75: 2177-82.   DOI
10 Pinheiro TG, Soares VY, Ferreira DB, Raymundo IT, Nascimento LA, Oliveira CA. Eagle's syndrome. Int Arch Otorhinolaryngol 2013; 17: 347-50.
11 Gossman JR Jr, Tarsitano JJ. The styloid-stylohyoid syndrome. J Oral Surg 1977; 35: 555-60.
12 Alcalde RE, Ueyama Y, Nishiyama A, Mizuguchi T, Matsumura T, Kishi K. Diagnostic imaging of Eagle's syndrome: report of three cases. Oral Radiol 1994; 10: 63-8.
13 Kermani H, Dehghani N, Aghdashi F, Esmaeelinejad M. Nonsyndromic isolated temporal bone styloid process fracture. Trauma Mon 2016; 21: e24395.
14 Gayathri G, Elavenil P, Sasikala B, Pathumai M, Krishnakumar Raja VB. 'Stylo-mandibular complex' fracture from a maxillofacial surgeon's perspective-review of the literature and proposal of a management algorithm. Int J Oral Maxillofac Surg 2016; 45: 297-303.   DOI
15 Dubey KN, Bajaj A, Kumar I. Fracture of the styloid process associated with the mandible fracture. Contemp Clin Dent 2013; 4: 116-8.   DOI
16 Blythe JN, Matthews NS, Connor S. Eagle's syndrome after fracture of the elongated styloid process. Br J Oral Maxillofac Surg 2009; 47: 233-5.   DOI
17 Smith GR, Cherry JE. Traumatic Eagle's syndrome: report of a case and review of the literature. J Oral Maxillofac Surg 1988; 46: 606-9.   DOI
18 Chase DC, Zarmen A, Bigelow WC, McCoy JM. Eagle's syndrome: a comparison of intraoral versus extraoral surgical approaches. Oral Surg Oral Med Oral Pathol 1986; 62: 625-9.   DOI
19 Chrcanovic BR, Custodio AL, de Oliveira DR. An intraoral surgical approach to the styloid process in Eagle's syndrome. Oral Maxillofac Surg 2009; 13: 145-51.   DOI
20 Strauss M, Zohar Y, Laurian N. Elongated styloid process syndrome: intraoral versus external approach for styloid surgery. Laryngoscope 1985; 95: 976-9.
21 Baseer MA, Alenazy MS. Eagle's syndrome: a rare case of young female. Dent Res J (Isfahan) 2013; 10: 568-70.
22 Mayrink G, Figueiredo EP, Sato FR, Moreira RW. Cervicofacial pain associated with Eagle's syndrome misdiagnosed as trigeminal neuralgia. Oral Maxillofac Surg 2012; 16: 207-10.   DOI
23 Rechtweg JS, Wax MK. Eagle's syndrome: a review. Am J Otolaryngol 1998; 19: 316-21.   DOI
24 Naik SM, Naik SS. Tonsillo-styloidectomy for Eagle's syndrome: a review of 15 cases in KVG Medical College Sullia. Oman Med J 2011; 26: 122-6.   DOI
25 Mupparapu M, Robinson MD. The mineralized and elongated styloid process: a review of current diagnostic criteria and evaluation strategies. Gen Dent 2005; 53: 54-9.
26 Feldman VB. Eagle's syndrome: a case of symptomatic calcification of the stylohyoid ligaments. J Can Chiropr Assoc 2003; 47: 21-7.
27 Han MK, Kim DW, Yang JY. Non surgical treatment of Eagle's syndrome - a case report -. Korean J Pain 2013; 26: 169-72.   DOI
28 Politi M, Toro C, Tenani G. A rare cause for cervical pain: Eagle's syndrome. Int J Dent 2009; 2009: 781297.
29 Chandler JR. Anatomical variations of the stylohyoid complex and clinical significance. Laryngoscope 1977; 87: 1692-701.
30 Murtagh RD, Caracciolo JT, Fernandez G. CT findings associated with Eagle syndrome. AJNR Am J Neuroradiol 2001; 22:1401-2.
31 Gokce C, Sisman Y, Sipahioglu M. Styloid process elongation or Eagle's syndrome: is there any role for ectopic calcification? Eur J Dent 2008; 2: 224-8.
32 Eagle WW. Symptomatic elongated styloid process: report of two cases of styloid process-carotid artery syndrome with operation. Arch Otolaryngol 1949; 49: 490-503.   DOI