Endoscope-Assisted Resection of Elongated Styloid Process Through a Retroauricular Incision: A Novel Surgical Approach to Eagle Syndrome

Abstract

Conventional resection of the elongated styloid process is associated with large-scale tissue dissection and poor surgical exposure. The purpose of this study was to show the feasibility, efficacy, and safety of a novel surgical approach using an endoscopic technique to treat Eagle syndrome. The authors implemented a retrospective cohort study composed of 133 patients undergoing endoscope-assisted styloidectomy (EAS) from June 2010 to August 2015 at a university teaching hospital. Outcome measurements included the length of the styloid process, blood loss, and duration of surgery. The simple verbal response scale for symptom relief, cosmetic appearance of the incision, and postoperative incision pain was used for the assessment of patients' subjective satisfaction. All patients underwent EAS without conversion to conventional surgery. One hundred seven patients (80.5%) achieved complete relief of symptoms, with 20 (15%) achieving partial relief. The residual length of the styloid process was 10.1 ± 4.4mm. One hundred seventy-two incision sides (75.8%) had no pain during the postoperative evaluation. One side (0.4%) showed slight transient facial paresis and 4 sides (1.8%) presented transient ear numbness. The vast majority of patients (122 of 133; 91.7%) considered the cosmetic appearance of the incision to be excellent. The results of this study suggest that EAS provides a viable surgical approach for Eagle syndrome in efficacy and safety.