Elongated Styloid Process

Abstract

The styloid process is a cylindrical, long osseous cartilaginous process located on the petrous part of temporal bone. Normal length of it usually 20-25 mm. The apex of it is connected with the lesser cornu of hyoid bone ipsilaterally through stylohyoid ligament. In the view of development stylohyoid ligament is the continuation of the styloid process apex, developed from second branchial arch. In present article we reported two skulls with bilateral elongated styloid process. In the first skull length of styloid process is 8.2cm on right and 5cm on left. In other skull 6.4cm on right and 5.2cm on left. INTRODUCTION The styloid process is extension of osseous process from the posterior lower surface of the petrous part of temporal bone located anteriorly to stylomastoid foramen. The direction of process is downwards and slightly inside. It is developed from second branchial arch [1]. The normal length of styloid process is 20-25mm, between apex of process and lesser cornu of hyoid bone there is attachment called as stylohyoid ligament. The tip of the process is situated laterally from the pharyngeal wall and immediately behind the tonsillor fossa and critically between the internal and external carotid arteries and has attachment of three muscles and two ligaments. Rarely stylohyoid ligament ossifies and increase the length of styloid process and called as elongated styloid process when it is longer than 30mm[2]. Clinically the relation of tip of the stylohyoid process is important, course of it situated in between external and internal carotid arteries, anteriomedially it is related to facial nerve, medially with accessory and vagus nerves. The one of the symptoms in Eagle`s syndrome is approximation of the glossopharyngeal nerve with the styloid ligament. The causes for the elongated styloid process or Eagle`s syndrome are the persistent angulation of the Reichert`s cartilage and its neurovascular relationships, styloid ligament ossification, osseous tissue growth at the insertion of the styloid ligament. The more common symptoms of this syndrome are dysphasia, headache, ipsilateral otolgia, foreign body sensation, neck pain during rotation, facial, carotid and throat pain [3, 4, 5]. CASE REPORT In routine osteology demonstration we have found out two dry adult skulls with the elongated styloid process. In the first skull right styloid process was 8.2cm long and 1.2 cm thick at the base which is extremely rare. The styloid process proper is 5.1cm long and remaining 3.1cm was ossified styloid ligament the junction between the two was marked by bulge of bony mass. The stylohyoid part broken was on the left side and it was 5cm long and 1cm thick at base (Figure 1. B). In second skull on the right side it was 6.4cm and 0.6cm thick at base and it was in two segments, on left side it was in only segment with 5.2cm length and 0.5cm thick at base(Figure 1. A). Figure 1. The Skull (A&B) showing elongated styloid process Hussain Saheb S et al /J. Pharm. Sci. & Res. Vol.4(3), 2012, 1761-1763