Eagle Syndrome: Case Report, Literature Review, Proposed Classification, and Role of Ultrasound in its Diagnosis and Management

Abstract

Eagle syndrome is defined by a spectrum of clinical presentations related to an elongated styloid process or calcified stylohyoid ligament, in the neck, which impinges on the adjacent nerves, arteries, or veins. It is an uncommon finding but one that should be considered in clinical and imaging practice. A variety of symptoms can result. The diagnosis is often delayed, particularly if it is not considered. Although the elongated styloid process may be seen on plain X-ray, contrast-enhanced computerized tomographic angiography (CTA) is considered the diagnostic test of choice. There is, however, a role for ultrasound in both the diagnosis and consideration of the differential diagnosis of Eagle syndrome. Vascular ultrasound specialists should be aware of this entity and be prepared to characterize the findings with ultrasound. Although medical management or endovascular approaches have been described, generally, surgical excision of the styloid process is recommended. Outcomes from such treatment tend to be excellent. Most reports describe a single patient or small series, and the role of duplex scanning has not been discussed. This patient is presented to allow a review of Eagle Syndrome, classify the types, and introduce the details of modern high-resolution color duplex scanning in its management.