Eagle syndrome: a case report

Yıl 2016, Cilt: 33 Sayı: 1, 30 - 4, 01.01.2016

Nilüfer Ersan , Mehmet İlgüy , Dilhan İlgüy

https://doi.org/10.17214/aot.25411

Öz

INTRODUCTION: Eagle syndrome, an uncommon sequela of elongation of the styloid process or calcification of the stylohyoid ligament, can manifest as pain in the face and the anterolateral neck, often with referred pain to the ear and the temporomandibular joint area.

CASE REPORT: A 43-year-old female patient presented to the Dentomaxillofacial Radiology Department with complaints of unremitting unilateral facial and neck pain, limitation in the movement of the neck, sensation of foreign body in the throat, dysphagia, and otalgia for a year. Systemic anamnesis of the patient was unremarkable. In the clinical examination, digital palpation of the tonsillar fossa aggravated the pain. The patient was being treated for temporomandibular joint disorder. A panoramic radiograph taken after the clinical examination revealed bilateral styloid process elongation. Cone-beam computed tomography also revealed bilateral ossification of the stylohyoid ligament which was measured as 71.5 mm and 69.6 mm on the right and the left side, respectively; and the patient was diagnosed as having Eagle syndrome. The patient was referred to the otolaryngology clinic for surgical treatment. Surgical shortening of the structure provided definitive relief in the patient's symptoms.

CONCLUSION: In cases of unexplained complaints in the head and neck region Eagle syndrome should be considered in the differential diagnosis as it may change the treatment approach.

Anahtar Kelimeler

Cone-beam computed tomography, dysphagia, Eagle syndrome

Eagle sendromu: olgu bildirimi

Öz

TANITIM: Eagle sendromu, kulak ve temporomandibular eklem bölgesine doğru yayılan, yüz ve boyun ağrısı şeklinde görülen, uzun stiloid çıkıntı veya kalsifiye stilohyoid ligamentin semptomatik halidir.

OLGU BİLDİRİMİ: 43 yaşındaki kadın hasta 1 yıldır boynun sağ tarafında, mandibulanın arkasından boynun yan tarafına ve kulağa doğru uzanan, tek taraflı, zaman zaman yutma güçlüğüne yol açan, yabancı cisim hissi veren ve boyun hareketlerinde kısıtlılığa neden olan ağrı şikayeti ile Dentomaksillofasiyal Radyoloji kliniğimize başvurdu. Sistemik hastalığı bulunmayan hastanın dental anamnezinde temporomandibuler eklem bozukluğu nedeniyle tedavi görmekte olduğu saptandı. Klinik muayenede tonsiller fossa palpasyonunda ağrının arttığı belirlendi. Rutin tarama için alınan panoramik radyografide çift taraflı uzun stiloid çıkıntı gözlendi. Konik ışınlı bilgisayarlı tomografide de stiloid ligamentin sağda 71.5 mm, solda 69.6 mm ölçülen çift taraflı kalsifikasyonu izlendi ve hastaya Eagle sendromu tanısı konuldu. Hasta cerrahi rezeksiyon için Kulak-Burun-Boğaz kliniğine yönlendirildi. Uzun stiloid çıkıntının cerrahi olarak kısaltılması ile hastalığın semptomlarında iyileşme sağlandı.

SONUÇ: Baş-boyun bölgesinde sebebi bulunamayan şikayetlerin varlığında tedavi protokolünü değiştirebilmesi nedeniyle Eagle Sendromu ayırıcı tanıda göz önünde bulundurulmalıdır.

Anahtar Kelimeler

Disfaji, Eagle sendromu, konik ışınlı bilgisayarlı tomografi

Kaynakça

• Nakamaru Y, Fukuda S, Miyashita S, Ohashi M. Diagnosis of the elongated styloid process by three-dimensional computed tomography. Auris Nasus Larynx 2002;29:55-7.
• Ferrario VF, Sigurtá D, Daddona A, Dalloca L, Miani A, Tafuro F, et al. Calcification of the stylohyoid ligament: Incidence and morphoquantitative evaluations. Oral Surg Oral Med Oral Pathol 1990;69:524-9.
• Loeser LH, Cardwell EP. Elongated styloid process, a case of the glosso-pharyngeal neuralgia. Arch Otolaryngol 1942;31:198-202.
• Thot B, Revel S, Mohandas R, Rao AV, Kumar A. Eagle’s syndrome. Anatomy of the styloid process. Indian J Dent Res 2000;11:65-70.
• Anbiaee N, Javadzadeh A. Elongated styloid process: is it a pathologic condition? Indian J Dent Res 2011;22:673-7.
• Fritz M. Elongated styloid process: cause of obscure throat symptoms. Arch Otolaryngol 1940;31:911-8.
• Correll RW, Jensen JL, Taylor JB, Rhyne RR. Mineralization of the stylohyoid-stylomandibular ligament complex. A radiographic incidence study. Oral Surg Oral Med Oral Pathol 1979;48:286-91.
• Mehta AK, Ravikumar R. Anomalous elongation of styloid process. Medical Journal Armed Forces India 2000;56:248-9.
• Jung T, Tschernitschek H, Hippen H, Schneider B, Borchers L. Elongated styloid process: when is it really elongated? Dentomaxillofac Radiol 2004;33:119-24.
• Ilgüy D, Ilgüy M, Fişekçioğlu E, Dölekoğlu S. Assessment of the stylohyoid complex with cone beam computed tomography. Iran J Radiol 2012;10:21-6.
• Kaufman SM, Elzay RP, Irish EF. Styloid process variation: radiologic and clinical study. Arch Otolarngol 1970;91:460-3.
• 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.
• 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.
• Slavin KV. Eagle syndrome: entrapment of the glossopharyngeal nerve? Case report and review of the literature. J Neurosurg 2002,97:216-8.
• Scarfe WC, Farman AG, Sukovic P. Clinical applications of conebeam computed tomography in dental practice. J Can Dent Assoc 2006;72:75-80.
• Ilgüy M, Ilgüy D, Güler N, Bayirli G. Incidence of the type and calcification patterns in patients with elongated styloid process. J Int Med Res 2005;33:96-102.
• Monsour PA, Young WG. Variability of the styloid process and stylohyoid ligament in panoramic radiographs. Oral Surg Oral Med Oral Pathol 1986;61:522-6.
• Eagle WW. Elongated styloid process: symptoms and treatment. Arch Otolaryngol 1958;67:172-6.
• Eagle WW. Elongated styloid process. Report of two cases. Arch Otolaryngol 1937;25:584-7.
• Fini G, Gasparini G, Filippini F, Becelli R, Marcotullio D. The long styloid process syndrome or Eagle’s syndrome. J Craniomaxillofac Surg 2000;28:123-7.