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Evaluation of styloid process elongation: a cross-sectional study

Year 2024, Volume: 7 Issue: 2, 180 - 184, 25.03.2024
https://doi.org/10.32322/jhsm.1409589

Abstract

Aims: The styloid process is a cylindrical projection of the temporal bone. When the length of the styloid process exceeds 30 mm, it is considered elongated. The aim of this study was to investigate the length, thickness and morphological pattern of the styloid process of patients using panoramic radiography and to evaluate the relationship with age and gender.
Methods: The study is designed retrospective cross-sectional and consisted of 3012 panoramic radiographs from patients routinely referred within the last six months, in which the borders of the styloid process region were clearly visualised on radiographs. Age and gender data of the patients were recorded. Styloid process was evaluated in terms of length, thickness and Langeais classification.
Results: The mean age of the patients was 38.32 years. 34.4% (n:1156) were male and 61.6% (n:1856) were female. The mean styloid process length was >30 for 32% of the patients. The thickness of the right styloid process was 2.73±1.56 and that of the left styloid process was 2.69±1.5. The length of the styloid process ranged between 0-79.98 mm with a mean of 26.12±10.78 mm. Most of the patients were in Langeais Type 1 class in right and left styloid process. There was a statistically significant correlation between the length, thickness and Langeais classification of right and left styloid process (p<0.01). There was a statistically significant correlation between age and styloid process length and thickness. Also, styloid process length and thickness were statistically greater in males than females (p<0.01).
Conclusion: In this study, the highest prevalence of elongation styloid process in Türkiye evaluated with panoramic radiographs is reported. Although styloid process elongation is mostly asymptomatic, more multicenter studies are needed to investigate the reasons for such a high prevalence.

References

  • 1. 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-e1452.
  • 2. Rath G, Anand C. Abnormal styloid process in a human skull. Surg Radiol Anat SRA. 1991;13(3):227-229.
  • 3. Scaf G, Freitas DQ de, Loffredo L de CM. Diagnostic reproducibility of the elongated styloid process. J Appl Oral Sci. 2003;11(2):120-124.
  • 4. Camarda AJ, Deschamps C, Forest DI. Stylohyoid chain ossification: a discussion of etiology. Oral Surg, Oral Med Oral Pathol. 1989;67(5):508-514.
  • 5. Koshy JM, Narayan M, Narayanan S, Priya BS, Sumathy G. Elongated styloid process: a study. J Pharm Bioallied Sci. 2015;7(Suppl 1):S131.
  • 6. Shaik MA, Kaleem SM, Wahab A, Hameed S. Prevalence of elongated styloid process in Saudi population of Aseer region. Eur J Dent. 2013;7(4):449-454.
  • 7. 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 Pathol. 1986;61(5):527-532.
  • 8. İlgüy D, İlgüy M, Fişekçioğlu E, Dölekoğlu S. Assessment of the stylohyoid complex with cone beam computed tomography. Iran J Radiol. 2013;10(1):21.
  • 9. Jeyaraj P. Etio‐histomorphogenesis of styloid enlargement—a novel and extensive light microscopic analysis of 10 cases of Eagle’s syndrome. Oral Surg. 2022;15(3):224-233.
  • 10. Fini G, Gasparini G, Filippini F, Becelli R, Marcotullio D. The long styloid process syndrome or Eagle’s syndrome. J Cranio-Maxillofac Surg. 2000;28(2):123-127.
  • 11. Gokce C, Sisman Y, Sipahioglu M. Styloid process elongation or eagle’s syndrome: is there any role for ectopic calcification. Eur J Dent. 2008;2(03):224-228.
  • 12. Al-Amad SH, Al Bayatti S, Alshamsi HA. Stylohyoid ligament calcification and its association with dental diseases. Int Dent J. 2023;73(1):151-156.
  • 13. Costantinides F, Della Flora F, Tonni I, et al. Elongation of the styloid processes in kidney-transplanted patients: the role of ectopic calcification as possible cause of Eagle syndrome. Cranio-J Craniomandib Pract. 2021;39(4):321-325.
  • 14. 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.
  • 15. Anbiaee N, Javadzadeh A. Elongated styloid process: Is it a pathologic condition. Indian J Dent Res. 2011;22(5):673-677.
  • 16. Piagkou M, Anagnostopoulou S, Kouladouros K, Piagkos G. Eagle’s syndrome: a review of the literature. Clin Anat Off J Am Assoc Clin Anat Br Assoc Clin Anat. 2009;22(5):545-558.
  • 17. Guimarães SMR, Carvalho ACP, Guimarães JP, Gomes MB, Cardoso M de MM, Reis HN. Prevalence of morphological alterations of the styloid process in patients with temporomandibular joint disorder. Radiol Bras. 2006;39(6):407-411.
  • 18. More CB, Asrani MK. Evaluation of the styloid process on digital panoramic radiographs. Indian J Radiol Imaging. 2010;20(04):261-265.
  • 19. 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(1):96-102.
  • 20. Şi̇şman Y, Gökçe C, Öztürk A, Akgunlu F, Tarım Ertaş E. Prevalence of styloid process elongation on panoramic radiography in the Turkiye population from Cappadocia region. Eur J Dent. 2007;2(01):18-22.
  • 21. Öztunç 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):5.
  • 22. de Andrade KM, Rodrigues CA, Watanabe PCA, Mazzetto MO. Styloid process elongation and calcification in subjects with TMD: clinical and radiographic aspects. Braz Dent J. 2012;23(4):443-450.
  • 23. Sisman Y, Gokce C, Tarim Ertas E, Sipahioglu M, Akgunlu F. Investigation of elongated styloid process prevalence in patients with torus palatinus. Clin Oral Investig. 2009;13(3):269-272.
  • 24. Akar GC, Alpoz E, Govsa F, Lomcali G. Does the state of dentition effect the type of stylohyoid chain calcification pattern? Surg Radiol Anat. 2016;38(7):817-823.
  • 25. Bagga MB, Kumar CA, Yeluri G. Clinicoradiologic evaluation of styloid process calcification. Imaging Sci Dent. 2012;42(3):155-161.
  • 26. Swapna LA, AlMegbil NT, Almutlaq AO, Koppolu P. Occurrence of the elongated styloid process on digital panoramic radiographs in the Riyadh population. Radiol Res Pract. 2021;2021:6097795.
  • 27. Sridevi K, Mahesh N, Krishnaveni B, Deepika AN, Thejasri V, Leninson BD. Evaluation of styloid process and its anatomical variations: a digital panoramic study with systematic review. J Int Soc Prev Community Dent. 2019;9(3):256.
  • 28. Shah SP, Praveen N, Syed V, Subhashini A. Elongated styloid process: a retrospective panoramic radiographic study. World J Dent. 2012;3(4):316-319.
Year 2024, Volume: 7 Issue: 2, 180 - 184, 25.03.2024
https://doi.org/10.32322/jhsm.1409589

Abstract

References

  • 1. 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-e1452.
  • 2. Rath G, Anand C. Abnormal styloid process in a human skull. Surg Radiol Anat SRA. 1991;13(3):227-229.
  • 3. Scaf G, Freitas DQ de, Loffredo L de CM. Diagnostic reproducibility of the elongated styloid process. J Appl Oral Sci. 2003;11(2):120-124.
  • 4. Camarda AJ, Deschamps C, Forest DI. Stylohyoid chain ossification: a discussion of etiology. Oral Surg, Oral Med Oral Pathol. 1989;67(5):508-514.
  • 5. Koshy JM, Narayan M, Narayanan S, Priya BS, Sumathy G. Elongated styloid process: a study. J Pharm Bioallied Sci. 2015;7(Suppl 1):S131.
  • 6. Shaik MA, Kaleem SM, Wahab A, Hameed S. Prevalence of elongated styloid process in Saudi population of Aseer region. Eur J Dent. 2013;7(4):449-454.
  • 7. 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 Pathol. 1986;61(5):527-532.
  • 8. İlgüy D, İlgüy M, Fişekçioğlu E, Dölekoğlu S. Assessment of the stylohyoid complex with cone beam computed tomography. Iran J Radiol. 2013;10(1):21.
  • 9. Jeyaraj P. Etio‐histomorphogenesis of styloid enlargement—a novel and extensive light microscopic analysis of 10 cases of Eagle’s syndrome. Oral Surg. 2022;15(3):224-233.
  • 10. Fini G, Gasparini G, Filippini F, Becelli R, Marcotullio D. The long styloid process syndrome or Eagle’s syndrome. J Cranio-Maxillofac Surg. 2000;28(2):123-127.
  • 11. Gokce C, Sisman Y, Sipahioglu M. Styloid process elongation or eagle’s syndrome: is there any role for ectopic calcification. Eur J Dent. 2008;2(03):224-228.
  • 12. Al-Amad SH, Al Bayatti S, Alshamsi HA. Stylohyoid ligament calcification and its association with dental diseases. Int Dent J. 2023;73(1):151-156.
  • 13. Costantinides F, Della Flora F, Tonni I, et al. Elongation of the styloid processes in kidney-transplanted patients: the role of ectopic calcification as possible cause of Eagle syndrome. Cranio-J Craniomandib Pract. 2021;39(4):321-325.
  • 14. 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.
  • 15. Anbiaee N, Javadzadeh A. Elongated styloid process: Is it a pathologic condition. Indian J Dent Res. 2011;22(5):673-677.
  • 16. Piagkou M, Anagnostopoulou S, Kouladouros K, Piagkos G. Eagle’s syndrome: a review of the literature. Clin Anat Off J Am Assoc Clin Anat Br Assoc Clin Anat. 2009;22(5):545-558.
  • 17. Guimarães SMR, Carvalho ACP, Guimarães JP, Gomes MB, Cardoso M de MM, Reis HN. Prevalence of morphological alterations of the styloid process in patients with temporomandibular joint disorder. Radiol Bras. 2006;39(6):407-411.
  • 18. More CB, Asrani MK. Evaluation of the styloid process on digital panoramic radiographs. Indian J Radiol Imaging. 2010;20(04):261-265.
  • 19. 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(1):96-102.
  • 20. Şi̇şman Y, Gökçe C, Öztürk A, Akgunlu F, Tarım Ertaş E. Prevalence of styloid process elongation on panoramic radiography in the Turkiye population from Cappadocia region. Eur J Dent. 2007;2(01):18-22.
  • 21. Öztunç 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):5.
  • 22. de Andrade KM, Rodrigues CA, Watanabe PCA, Mazzetto MO. Styloid process elongation and calcification in subjects with TMD: clinical and radiographic aspects. Braz Dent J. 2012;23(4):443-450.
  • 23. Sisman Y, Gokce C, Tarim Ertas E, Sipahioglu M, Akgunlu F. Investigation of elongated styloid process prevalence in patients with torus palatinus. Clin Oral Investig. 2009;13(3):269-272.
  • 24. Akar GC, Alpoz E, Govsa F, Lomcali G. Does the state of dentition effect the type of stylohyoid chain calcification pattern? Surg Radiol Anat. 2016;38(7):817-823.
  • 25. Bagga MB, Kumar CA, Yeluri G. Clinicoradiologic evaluation of styloid process calcification. Imaging Sci Dent. 2012;42(3):155-161.
  • 26. Swapna LA, AlMegbil NT, Almutlaq AO, Koppolu P. Occurrence of the elongated styloid process on digital panoramic radiographs in the Riyadh population. Radiol Res Pract. 2021;2021:6097795.
  • 27. Sridevi K, Mahesh N, Krishnaveni B, Deepika AN, Thejasri V, Leninson BD. Evaluation of styloid process and its anatomical variations: a digital panoramic study with systematic review. J Int Soc Prev Community Dent. 2019;9(3):256.
  • 28. Shah SP, Praveen N, Syed V, Subhashini A. Elongated styloid process: a retrospective panoramic radiographic study. World J Dent. 2012;3(4):316-319.
There are 28 citations in total.

Details

Primary Language English
Subjects Oral and Maxillofacial Surgery
Journal Section Original Article
Authors

Berkan Altay 0000-0003-0297-6501

Elif Çoban 0000-0003-0762-7941

Şeyma Kale 0000-0003-1309-6243

Özlem Arık 0000-0002-9427-3733

Publication Date March 25, 2024
Submission Date December 25, 2023
Acceptance Date March 2, 2024
Published in Issue Year 2024 Volume: 7 Issue: 2

Cite

AMA Altay B, Çoban E, Kale Ş, Arık Ö. Evaluation of styloid process elongation: a cross-sectional study. J Health Sci Med / JHSM. March 2024;7(2):180-184. doi:10.32322/jhsm.1409589

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