Vascular Type Eagle Syndrome: A Case of Styloid Process-Carotid Artery Syndrome with Operation

Abstract

Eagle’s syndrome (ES), also known as the stylohyoid syndrome, is defined as the elongation of a styloid process by more than 30 mm and the mineralization of the stylohyoid-stylomandibular ligament. Two types of ES are described in the literature: classical stylohyoid syndrome and vascular stylocarotid syndrome. While bilateral ES is commonly seen in women, the symptoms are usually unilateral. This case report describes the surgical treatment of a 45-year-old female patient with bilaterally-elongated styloid processes who presented with vascular ES symptoms. A literature review is also included.

 

 

Eagle Sendromu (ES) veya Stilohyoid Sendromu, stiloid prosesin 30 mm'den fazla uzaması ve stilohyoid-stilomandibular ligamentin mineralizasyonu olarak tanımlanmaktadır. Literatürde iki ES formu tanımlanmaktadır. Bunlar klasik tip stilohyoid sendrom ve vasküler tip stilokarotid sendromudur. ES sıklıkla kadınlarda ve bilateral olarak görülürken, belirtiler genellikle tek taraflıdır. Bu olguda bilateral olarak uzamış stiloid prosesi olan ve Eagle tipi sendromun vasküler tipini destekleyen semptomlarla başvuran 45 yaşında bir kadın hasta ele alınmış ve ilgili literatür sunulmuştur.

Keywords

• Styloid process,calcification,carotid artery,Eagle’s syndrome,panoramic image

References

1. 1. Carter L. Soft tissue calcification and ossification. In: White SC, Pharoah MJ, editors. Oral radiology, principles and interpretation. Missouri: Mosby; 2004. pp. 597–614.
2. 2. Eagle WW. Elongated styloid process; further observations and a new syndrome. Arch Otolaryngol. 1948; 47(5):630-640.
3. 3. Chebbi R, Chaabani I, Alaya TB, Dhidah M. Elongated styloid process as a cause of facial pain. Joint Bone Spine. 2014;81(4):368.
4. 4. Bafaqeeh SA. Eagle syndrome: classic and carotid artery types. J Otolaryngol. 2000;29(2):88-94.
5. 5. Diamond LH, Cottrell DA, Hunter MJ, Papageorge M. Eagle's syndrome: a report of 4 patients treated using a modified extraoral approach. J Oral Maxillofac Surg. 2001;59(12):1420-6.
6. 6. Sokler K, Sandev S. New classification of the styloid process length--clinical application on the biological base. Coll Antropol. 2001;25(2):627-32.
7. 7. Chuang WC, Short JH, McKinney AM, Anker L, Knoll B, McKinney ZJ. Reversible left hemispheric ischemia secondary to carotid compression in Eagle syndrome: surgical and CT angiographic correlation. AJNR Am J Neuroradiol. 2007;28 (1): 143-5.
8. 8. Mendelsohn AH, Berke GS, Chhetri DK. Heterogeneity in the clinical presentation of Eagle's syndrome. Otolaryngol Head Neck Surg. 2006;134(3):389-93.

9. 9. Farhat HI, Elhammady MS, Ziayee H, Aziz-Sultan MA, Heros RC. Eagle syndrome as a cause of transient ischemic attacks. J Neurosurg. 2009;110(1):90-3.
10. 10. Emary PC, Dornink M, Taylor JA. A rare case of Eagle syndrome and diffuse idiopathic skeletal hyperostosis in the cervical spine. J Can Chiropr Assoc. 2017;61(2):167-170.
11. 11. Mutlu V, Ogul H. Coincidence of Eagle Syndrome and Diffuse Idiopathic Skeletal Hyperostosis Presenting With Dysphagia as a Result of Compression of the Hypopharynx. J Craniofac Surg. 2017;28(2):e129-e130.
12. 12. Hoffmann E, Räder C, Fuhrmann H, Maurer P. Styloid-carotid artery syndrome treated surgically with Piezosurgery: a case report and literature review. J Craniomaxillofac Surg. 2013;41(2):162-6.
13. 13. Ramachandra KK, Krishnan SA, Reddy SS. Carotid type of Eagle's syndrome. J Indian Soc Periodontol. 2015;19(3):336-8.
14. 14. Ilguy M, Ilguy D, Guler N, Bayirli G. Incidence of the type and calcification patterns in patients with elongated styloid process. J Int Med Res. 2005;33:96–102.
15. 15. Prasad KC, Kamath MP, Reddy KJ, Raju K, Agarwal S. Elongated styloid process (Eagle’s syndrome): a clinical study. J Oral Maxillofac Surg. 2002;60:171–175.
16. 16. Jung T, Tschernitschek H, Hippen H, Schneider B, Borchers L. Elongated styloid process: when is it really elongated? Dentomaxillofac Radiol. 2004;33:119–124.
17. 17. Gokce C, Sisman Y, Tarim Ertas E, Akgunlu F, Ozturk A. Prevalence of styloid process elongation on panoramic radiography in the Turkey population from Cappodocia region. Eur J Dent. 2008;2:18–22.
18. 18. Fini G, Gasparini G, Filippini F, Becelli R, Marcotullio D. The long styloid process syndrome or Eagle’s syndrome. J Craniomaxillofac Surg. 2000;28(2):123-7.
19. 19. Keur JJ, Campbell JPS, McCarthy JF, Ralph WJ. The clinical significance of the elongated styloid process. Oral Surg Oral Med Oral Pathol 1986; 61: 399-404.
20. 20. Ferrario VF, Sigurtá D, Daddona A, Dalloca L, Miani A, Tafuro F, Sforza C. Calcification of the stylohyoid ligament: incidence and morphoquantitative evaluations. Oral Surg Oral Med Oral Pathol. 1990;69(4):524-9 23.
21. 21. Savranlar A, Uzun L, Uğur M. B, Özer T. Three-dimensional CT of Eagle’s syndrome. Diagn Intervent Radiol 2005; 11:206-209