Eagle syndrome – from symptom to diagnosis. Case report

Abstract

Introduction: Eagle syndrome is a rare condition caused by elongation of the styloid process or ossification of the stylohyoid ligament. It’s named after Watt W. Eagle an otolaryngologist at Duke university, who described the first case in 1937. In the clinical presentation, we found different signs of syndrome – dysphagia, odynophagia, otalgia, foreign body sensation, facial pain, trismus, headache, increased salivation, and/or voice changes. The diagnosis of Eagle’s syndrome is based on an optimal medical history and physical examination. The most accurate imaging technique is the CT- scan. 3-D CT reconstruction of the neck specify the size of length of the styloid process (>3 mm) and the ossified stylohyoid ligament. The treatment includes conservative and surgical approach. Material and methods: We present a 65- years old female, in a good health condition, with the following complains: difficulty swallowing, foreign body sensation in the throat. The patient states that she had palpated cartilage in the right side in the area of the tonsillar fossa. The physical examination revealed no abnormal findings, but palpable right styloid process. We performed CT and 3-D CT reconstruction, which showed an elongation of styloid process on right side. Results: The patient refused the surgical treatment. The conservative therapy includes the nonsteroidal anti- inflammatory medications. Conclusion: Eagle’s syndrome is a rare condition with vast differential diagnosis, vague symptomatology and ambiguous incidence and etiology. When we suggest the syndrome, the CT scan is the imaging method of choice for diagnosis. It shows the measurement of styloid process, the position in the neurovascular complex and the prepositions of damages. The treatment can be surgical or non-surgical depend on the size, position and surgical risk of the approach