• Title/Summary/Keyword: Fracture of styloid process

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Cervico-stylo-mandibular complex fracture: a critical review of literature along with a protocol to recognize and proposal of a new classification

  • Donepudi, Nanda Kishore;Naik, Vinayak Gourish;Rai, Kirthi Kumar
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.45 no.6
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    • pp.302-308
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    • 2019
  • Fractures of the styloid process of the temporal bone may occur with or without an obvious relation to trauma. The incidence of either isolated styloid process fracture or in combination with mandibular fractures is rare, and such occurrences are often misdiagnosed or neglected. A fractured styloid when displaced may impinge on adjacent vital structures, leading to neurological or vascular symptoms that vary according to the anatomical structure compressed. Styloid process fractures associated with atlas/C1 fractures have also been rarely reported in the literature. In this review of literature, the majority of patients was treated conservatively, as few demonstrated the necessity of surgical intervention. There is a definitive need for a protocol to recognize and classify styloid fractures to plan for further treatment. The aim of this review was to achieve a comprehensive understanding of all types of styloid fractures, determine the clinical severity of symptoms, and to consider management and prognosis. In addition, a new classification of cervico-stylo-mandibular fractures is proposed based on important evidence in the literature regarding clinical and radiographic factors that might influence the treatment and prognosis of such fractures.

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

  • Khan, Hassan M.;Fraser, Andrew D.;Daws, Steven;Thoppay, Jaisri;Mupparapu, Mel
    • Imaging Science in Dentistry
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    • v.48 no.1
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    • pp.67-72
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    • 2018
  • 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.

Eagle's Syndrome Presenting Unilateral Facial Nerve Palsy: Case Report (편측 안면신경 마비를 동반한 Eagle 증후군 치험례)

  • Shin, Hee-Jin;Kwon, Young-Wook;Cho, Sung-Min;Kim, Change-Hyen;Park, Je-Uk
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.5
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    • pp.467-472
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    • 2010
  • Eagle's syndrome is the manifestation of elongated styloid process that is not a common entity in dental clinics. Without the knowledge of this syndrome misdiagnosis can be made and therefore differential diag-nosis with other diseases of oral and maxillofacial area is required. The symptoms of elongated styloid process are cervical pain, foreign body sensation, dysphagia and pharyngeal pain. A 27 years old male vis-ited our hospital. He had cervical pain with unilateral facial nerve palsy. Along with meticulous clinical examinations, 3D-CT, Plain radiographic studies were used to make the diagnosis. In computed tomogra-phy, Lt. styloid process was elongated and fractured. Patient have undergone surgical resection of elongat-ed styloid process and have been carefully observed. Characteristically, preoperative facial nerve palsy showed rapid postoperative recovery. The other clinical symptoms that were present in the initial visit were diminished. The purpose of this article is to report a case of Eagle's syndrome presenting unilateral facial nerve palsy that was treated with transoral surgical approach with literature review.

Comparison of the Outcomes according to the Injury Type of the Short Radiolunate Ligament in Fracture-Dislocation of the Radiocarpal Joint (요수근 관절의 골절-탈구에서 단요월상인대의 손상 형태에 따른 치료 결과의 비교)

  • Heo, Youn Moo;Kim, Tae Gyun;Song, Jae Hwang;Jang, Min Gu;Lee, Seok Won
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.1
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    • pp.51-60
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    • 2021
  • Purpose: Radiocarpal dislocation (RCD), which is caused by high-energy trauma, often involves radial styloid fractures and short radiolunate ligament (SRLL) injuries. Although SRLL injuries may occur as a simple rupture at the attachment site of radius, it may occur with a relatively large avulsed-fragment in the volar rim of the lunate facet of the radius. This study aimed to differentiate the injury type of SRLL and assess the differences in the treatment results depending on the treatment methods that have been applied in RCD with radial styloid fractures. Materials and Methods: Eighteen patients managed surgically with RCD were enrolled in this study. The patients were classified as Group 1 and Group 2 by using the Dumontier method. In this study, Group 2 was subdivided into 2A (purely ligamentous or small avulsion fracture of the volar rim of lunate facet) and 2B (large avulsed-fragment enough to internal fixation) according to the injury type of SRLL. Groups 2A and 2B were treated with direct repair and screw fixation, respectively. Pain, range of motion of the wrist joint, grip strength, and complications on final radiographs were examined. The outcomes were evaluated using patient-rated wrist evaluation (PRWE), and modified Mayo wrist score (MMWS). Results: All patients were Group 2 (six and twelve patients in 2A and 2B, respectively). The mean flexion to extension arch recovered 79%,and the mean grip strength was 72.9% of the uninjured side. Group 2A showed better recovery in extension, flexion and pronation than Group 2B, but there was no difference in radial deviation, ulnar deviation, supination, grip strength and pain. No differences in the PRWE and MMWS were observed between two groups. Complications included traumatic arthritis in seven patients and residual instability in five patients. Conclusion: When the SRLL was injured, the involvement of a large avulsion fracture on the anterior plane of the radiolunate did not affect the test results. On the other hand, it should be observed cautiously because avulsion fractures tend to disturb the joint's reduction through rotation or displacement. In addition, anatomical reduction and sturdy internal fixation are important for restoring the function of the SRLL.

REMOVAL OF FOREIGN BODY IN THE LATERAL PHARYNGEAL SPACE VIA TRANSTONSILLAR APPROACH (편도와 접근을 통한 측방인두간극 이물제거의 치험 증례)

  • Kim, Soung-Min;Kim, Han-Seok;Kim, Ji-Hyuck;Kwon, Kwang-Jun;Park, Young-Wook
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.5
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    • pp.567-571
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    • 2007
  • Lateral pharyngeal space is one of potential fascial planes of head and neck, that may become involved by various pathological processes, such as infection, inflammation and neoplasm. The calcified stylohyoid ligament with styloid process is also located in this space, so this space is more acquainted with Eagle's syndrome in oral and maxillofacial field. During the mandibular transbuccal fixation procedures of 29-year old female patient who had right condylar neck and left parasymphysis fracture, we had lost one 10.0 mm miniscrew. After confirming the location of the lost miniscrew from different angled plain skull radiographies, we tried to find it in the lateral pharyngeal space via transtonsillar approach at the time of plate removal operation. This case report is aimed to share our valuable experience of the effective approach way to the lateral pharyngeal space, which has many advantages, such as short operative time, minimal bleeding, fast post-operative recovery, and less morbidity. The related literature is also reviewed.