Prevalence and Pattern of Stylohyoid Chain Complex on Panoramic Radiographs: A Retrospective Study

Yıl 2022, Cilt: 12 Sayı: 4, 906 - 912, 30.12.2022

Ali Altındağ Hakan Eren Muhammed Küçükkalem Ömer Altındağ

https://doi.org/10.33808/clinexphealthsci.980990

Cited By: 1

Öz

Objective: The elongated styloid process (SP) and calcified stylohyoid ligament can be evaluated radiologically and are associated with some symptoms and syndromes. This study aimed to define the incidence of different stylohyoid chain patterns and classify them.
Methods: Digital panoramic radiographs of 1217 patients were included in the study. The styloid chain patterns were analyzed according to MacDonald-Jankowski’s study. Data analysis was performed using the IBM SPSS Statistics 21.0 (Statistical Package for Social Sciences) program.
Descriptive values were analyzed by using descriptive statistics. The data were assessed by using Chi-squared tests. A probability level of less than .05 (p ˂ .05) was considered significant.
Results: The prevalence of the stylohyoid chain complex patterns was higher for normal SP (86.5%), followed by elongated SP (7.1%), calcified stylohyoid ligament (2.2%), and absent stylohyoid chain (2.8%). Unclassified SP was detected in twenty individuals on the left (1.6%) and fourteen on the right (1.2%). In view of symmetry of the stylohyoid chain complex, 979 (80.4%) were symmetric, 238 (19.6%) were asymmetric and 14 (1.15%) of the asymmetrical ones were unilateral. There was no significant difference in gender for the type of stylohyoid chain complex pattern (p > .05). There was statistically significant difference between the stylohyoid complex pattern and age groups for the right and left
sides (p < .05).
Conclusion: The authors believe that this study provides additional information about the frequency of the elongated styloid process and provides valuable knowledge of the anatomical variations of the SP. Current findings should be correlated with clinical symptoms in future studies

Anahtar Kelimeler

styloid process, digital panoramic radiography, diagnostic imaging, ossification, Eagle's Syndrome

Kaynakça

• [1] Monsour PA, Young WG. Variability of the styloid process and stylohyoid ligament in panoramic radiographs. Oral Surg Oral Med Oral Path. 1986;61(5):522-526. DOI: 10.1016/0030- 4220(86)90399-3
• [2] Öztaş B, Orhan K. Investigation of the incidence of stylohyoid ligament calcifications with panoramic radiographs. J Investig Clin Dent. 2012;3(1):30-35. DOI: 10.1111/j.2041- 1626.2011.00081.x
• [3] Neville B, Damm D, Allen C, Bouquot JE. Developmental defects of the oral and maxillofacial region. Oral Maxiollofac Path. 2002;3:37-38.
• [4] Sancak B, Cumhur M. Kafa Kemikleri. Sancak B, Cumhur M, editors. Fonksiyonel anatomi (Baş-boyun ve iç organlar) 4th ed. Ankara:ODTÜ yayıncılık; 2004.p.21-23(Turkish)
• [5] Ghosh LM, Dubey SP. The syndrome of elongated styloid process. Auris Nasus Larynx. 1999;26(2):169-175. DOI: 10.1016/S0385-8146(98)00079-0
• [6] Moon CS, Lee BS, Kwon YD, Choi BJ, Lee JW, Lee HW, Yun SU, Ohe JY. Eagle’s syndrome: a case report. J Korean Assoc Oral Maxillofac Surg. 2014;40(1):43-47. DOI: 10.5125/ jkaoms.2014.40.1.43
• [7] 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):123-127. DOI: 10.1054/ jcms.2000.0128
• [8] İlgüy M, İlgüy D, Güler N, Bayirli G. Incidence of the type and calcification patterns in patients with elongated styloid process. J Int Med Res. 2005;33(1):96-102. DOI: 10.1177/147.323.000503300110
• [9] 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 Path. 1986;61(5):527-532. DOI: 10.1016/0030- 4220(86)90400-7
• [10] Eagle WW. Elongated styloid processes: report of two cases. Arch Otolaryngol. 1937;25(5):584-587. DOI: 10.1001/ archotol.1937.006.50010656008
• [11] Kaufman SM, Elzay RP, Irish EF. Styloid process variation: radiologic and clinical study. Arch Otolaryngol. 1970;91(5):460- 463. DOI: 10.1001/archotol.1970.007.70040654013
• [12] Keur J, Campbell J, McCarthy J, Ralph WJ. The clinical significance of the elongated styloid process. Oral Surg Oral Med Oral Path. 1986;61(4):399-404. DOI: 10.1016/0030- 4220(86)90426-3
• [13] Savranlar A, Uzun L, Uğur MB, Ozer T. Three-dimensional CT of Eagle’s syndrome. Diagn Interv Radiol. 2005;11(4):206-209.
• [14] Yavuz H, Caylakli F, Yildirim T, Ozluoglu LN. Angulation of the styloid process in Eagle’s syndrome. Eur Arch Otorhinolaryngol. 2008;265(11):1393-1396. DOI: 10.1007/ s00405.008.0686-9
• [15] Piagkou M, Anagnostopoulou S, Kouladouros K, Piagkos G. Eagle’s syndrome: a review of the literature. Clin Anat. 2009;22(5):545-558. DOI: 10.1002/ca.20804
• [16] Koivumäki A, Marinescu-Gava M, Järnstedt J, Sándor G, Wolff J. Trauma induced eagle syndrome. Int J Oral Maxillofac Surg. 2012;41(3):350-353. DOI: 10.1016/j.ijom.2011.12.031
• [17] Diamond LH, Cottrell DA, Hunter MJ, Papageorge M. Eagle’s syndrome: a report of 4 patients treated using a modified extraoral approach. J Oral Maxiollofac Surg. 2001;59(12):1420- 1426. DOI: 10.1053/joms.2001.28276
• [18] Stafne EC, Hollinshead WH. Roentgenographic observations on the stylohyoid chain. Oral Surg Oral Med Oral Path. 1962;15(10):1195-1200. DOI: 10.1016/0030- 4220(62)90154-8
• [19] Nogueira-Reis F, de Oliveira Reis L, Fontenele RC, Freitas DQ, Tabchoury CPM. Prevalence and features of elongated styloid process on imaging studies: a systematic review and meta-analysis. Clin Oral Investig. 2021;1-17. DOI: 10.1007/ s00784.021.04285-w
• [20] MacDonald-Jankowski DS. Calcification of the stylohyoid complex in Londoners and Hong Kong Chinese. Dentomaxillofac Radiol. 2001;30(1):35-39. DOI: 10.1038/sj/ dmfr/4600574
• [21] Rodríguez-Vázquez J, Mérida-Velasco J, Verdugo-López S, Sánchez-Montesinos I, Mérida-Velasco JA. Morphogenesis of the second pharyngeal arch cartilage (Reichert’s cartilage) in human embryos. J Anat. 2006;208(2):179-189. DOI: 10.1111/j.1469-7580.2006.00524.x
• [22] Patil S, Ghosh S, Vasudeva N. Morphometric study of the styloid process of temporal bone. J Clin Diagn Res. 2014;8(9):AC04. DOI: 10.7860/JCDR/2014/9419.4867
• [23] Kursoglu P, Unalan F, Erdem T. Radiological evaluation of the styloid process in young adults resident in Turkey’s Yeditepe University faculty of dentistry. Oral Surg Oral Med Oral Path Oral Radio Oral End. 2005;100(4):491-4. DOI: 10.1016/j. tripleo.2005.05.061
• [24] Pereira FL, Iwaki Filho L, Pavan AJ, Farah GJ, Gonçalves EAL, Veltrini VC, Camarini ET. Styloid-stylohyoid syndrome: literature review and case report. J Oral Maxillofac Surg. 2007;65(7):1346-1353. DOI: 10.1016/j.joms.2006.07.020
• [25] Ferrario VF, Sigurta 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 Path. 1990;69(4):524-529. DOI: 10.1016/0030- 4220(90)90390-E
• [26] Mortellaro C, Biancucci P, Picciolo G, Vercellino V. Eagle’s syndrome: importance of a corrected diagnosis and adequate surgical treatment. J Craniofac Surg. 2002;13(6):755-758. DOI: 10.1097/00001.665.200211000-00007
• [27] Slavin KV. Eagle syndrome: entrapment of the glossopharyngeal nerve?: Case report and review of the literature. J Neurosurg. 2002;97(1):216-8. DOI: 10.3171/jns.2002.97.1.0216
• [28] Eagle W. Elongated styloid process: symptoms and treatment. AMA Arch Otolaryngol. 1958;67(2):172-176. DOI: 10.1001/ archotol.1958.007.30010178007
• [29] Orhan KS, Güldiken Y, Ural Hİ, Çakmak A. Elongated styloid process (Eagle’s syndrome): literature review and a case report. Agri. 2005;17(2):23-25. (Turkish)
• [30] Alpoz E, Akar GC, Celik S, Govsa F, Lomcali G. Prevalence and pattern of stylohyoid chain complex patterns detected by panoramic radiographs among Turkish population. Surg Radiol Anat. 2014;36(1):39-46. DOI: 10.1007/s00276.013.1137-x
• [31] Okabe S, Morimoto Y, Ansai T, Yamada K, Tanaka T, Awano S, Kito S, Takata Y, Takehara T, Ohba T. Clinical significance and variation of the advanced calcified stylohyoid complex detected by panoramic radiographs among 80-year-old subjects. Dentomaxillofac Radiol. 2006;35(3):191-199. DOI: 10.1259/dmfr/12056500
• [32] Watanabe P, Dias F, Issa J, Monteiro S, De Paula F, Tiossi R. Elongated styloid process and atheroma in panoramic radiography and its relationship with systemic osteoporosis and osteopenia. Osteoporos Int. 2010;21(5):831-836. DOI: 10.1007/s00198.009.1022-y
• [33] Carroll MKO. Calcification in the stylohyoid ligament. Oral Surg Oral Med Oral Path. 1984;58(5):617-21. DOI: 10.1016/0030- 4220(84)90089-6
• [34] Oztunç H, Evlice B, Tatli U, Evlice A. Cone-beam computed tomographic evaluation of styloid process: a retrospective study of 208 patients with orofacial pain. Head Face Med. 2014;10(1):1-7. DOI: 10.1186/1746-160X-10-5
• [35] Andrei F, Motoc AGM, Didilescu AC, Rusu MC. A 3D cone beam computed tomography study of the styloid process of the temporal bone. Folia Morphol. 2013;72(1):29-35. DOI: 10.5603/FM.2013.0005
• [36] Gözil R, Yener N, Calgüner E, Araç M, Tunç E, Bahçelioğlu M. Morphological characteristics of styloid process evaluated by computerized axial tomography. Ann Anat. 2001;183(6):527- 535. DOI: 10.1016/s0940-9602(01)80060-1
• [37] Başekim CC, Mutlu H, Güngör A, Silit E, Pekkafali Z, Kutlay M, Çolak A, Öztürk E, Kizilkaya E. Evaluation of styloid process by three-dimensional computed tomography. Eur Radiol. 2005;15(1):134-139. DOI: 10.1007/s00330.004.2354-9
• [38] Omami G. Calcification of the stylohyoid complex in Libyans. Saudi Dent J. 2018;30(2):151-154. DOI: 10.1016/j. sdentj.2017.12.003
• [39] Reddy RS, Kiran CS, Madhavi NS, Raghavendra MN, Satish A. Prevalence of elongation and calcification patterns of elongated styloid process in south India. J Clin Exp Dent. 2013;5(1):e30. DOI: 10.4317/jced.50981
• [40] Bagga MB, Kumar CA, Yeluri G. Clinicoradiologic evaluation of styloid process calcification. Imaging Sci Dent. 2012;42(3):155- 161. DOI: 10.5624/isd.2012.42.3.155
• [41] Rizzatti-Barbosa CM, Ribeiro MC, Silva-Concilio LR, Di Hipolito O, Ambrosano GM. Is an elongated stylohyoid process prevalent in the elderly? A radiographic study in a Brazilian population. Gerodontology. 2005;22(2):112-115. DOI: 10.1111/j.1741-2358.2005.00046.x
• [42] Andrade KMd, Rodrigues CA, Watanabe PCA, Mazzetto MO. Styloid process elongation and calcification in subjects with TMD: Clinical and radiographic aspects. Braz Dent J. 2012;23:443-450. DOI: 10.1590/S0103.644.0201200.040.0023
• [43] Vieira EMM, Guedes OA, De Morais S, De Musis CR, De Albuquerque PAA, Borges ÁH. Prevalence of elongated styloid process in a central Brazilian population. J Clin Diaggn Res. 2015;9(9):ZC90. DOI: 10.7860/JCDR/2015/14599.6567
• [44] More CB, Asrani MK. Evaluation of the styloid process on digital panoramic radiographs. Indian J Radiol Imaging. 2010;20(4):261. DOI: 10.4103/0971-3026.73537
• [45] Ekici F, Tekbas G, Hamidi C, Onder H, Goya C, Cetincakmak MG, Gumus H, Uyar A, Bilici A. The distribution of stylohyoid chain anatomic variations by age groups and gender: an analysis using MDCT. Eur Arch Otorhinolaryngol. 2013;270(5):1715- 1720. DOI: 10.1007/s00405.012.2202-5
• [46] Gokce C, Sisman Y, Ertas ET, Akgunlu F, Ozturk A. Prevalence of styloid process elongation on panoramic radiography in the Turkey population from cappadocia region. Eur J Dent. 2008;2(01):18-22. DOI: 10.1055/s-0039.169.7348
• [47] Bruno G, De Stefani A, Balasso P, Mazzoleni S, Gracco A. Elongated styloid process: an epidemiological study on digital panoramic radiographs. J Clin Exp Dent. 2017;9(12):e1446. DOI: 10.4317/jced.54370
• [48] Tassoker M, Magat G. Investigation of the prevalence of styloid process elongation on digital panoramic radiographs in turkish population. J Ege Univ Fac Dent. 2015;36(2), 67-73. DOI: 10.5505/eudfd.2015.65487 (Turkish)
• [49] Magat G, Ozcan S. Evaluation of styloid process morphology and calcification types in both genders with different ages and dental status. J Istanb Univ Fac Dent. 2017;51(2):29-36. DOI: 10.17096/jiufd.35768