Evaluation of the length and angulation of the styloid process in the patient with pre-diagnosis of Eagle syndrome

Abstract

Clinical symptoms caused by the elongated styloid process (SP) or calcified stylohyoid ligament were first described by W. Eagle and they are now known as Eagle syndrome (ES). Normal length of SP was stated by Eagle as 2.5 cm. The objective of this study was to determine and discuss the length of SP and medial angulation degree with computed tomography (CT), which is an affective modality in the identification of ES, and a comparison with related studies. Three-dimensional (3D) images obtained from the axial CT scans of 22 cases (11 males and 11 females) aged between 24 and 80 years, who referred to Cumhuriyet University Hospital, Department of Radiology for multi slice CT with the pre-diagnosis of ES, were used. Lengths of the SP and medial angulations were measured on the obtained images. Inter- and intra-group comparisons were carried out using Wilcoxan and Mann-Whitney U tests. The mean length of the SP was found as 4.1 +/- 1.1 cm. When inter- and intra-group lengths of the right and left SP were compared, the difference was not significant (p > 0.05). The mean medial angulation of the SP was found as 67.5 +/- 5.1 degrees. There was a significant difference found between the right side medial angulation and left side medial angulation in all persons (p < 0.05). Lengths of the right and left SP of the patients with pre-diagnosis of ES were close to each other. However, the right-side angulation was observed to be smaller than the left medial angulation in all the patients. Similarly, right side medial angulation of the females was smaller than the left side medial angulation, but this difference was absent in the males. Eagle syndrome should be kept in mind in patients with a sore throat radiating to the ears with swallowing and an observed non-compliance between the complaints such as feeling a foreign body in the throat and facial pain, and physical examination of those who do not have a response to long-term medical therapy should be performed. (Folia Morphol 2011; 70,4: 295-299)