Evaluation of Eagle's Syndrome and Assessment of Post-operative Outcome of Excision of Elongated Styloid Process: A Prospective Study, in Tertiary Care Centre, India.

Abstract

Eagle's syndrome is one of the commonly overlooked cause of foreign body sensation in throat with referred otalgia. Incidence of symptomatic cases was rare. Elongated Styloid process may present with myriad symptoms. The diagnosis needs a cautious approach and the management is mainly aimed at reduction of the length of elongated section. Prospective study in the Department of ENT Stanley Medical College, Chennai. Study period-January 2018 to September 2018. Clinical examination followed by radiological investigations done to confirm the diagnosis. Stylo-tonsillectomy was done in the selected 20 subjects and post-operative outcomes were compared with pre-operative questionnaires. The progression of symptoms were evaluated for resolution and studied. Pharyngeal symptoms are more common. The length of styloid is associated with symptom complex presentation. The incidence was 0.17% in general population coming to ENT OPD and more common among women with mean age of 43years. Bilateral presentation was more common and the longest length recorded in the study was 78mm. Single investigation is not enough to confirm the diagnosis. A minimum of two investigations are needed for planning surgical management. Intra-oral approach with stylo-tonsillectomy was done with no major complications in post-operative period. Pre-operative symptoms were recoreded by use of McGill's pain questionnaire and compared with post-operative scores. Dysphagia was the major post-operative early symptom which took a week minimum to subside. Clinical findings and atleast 2 imaging studies needed for diagnosis of the disorder. OPG though economical can be aided to great extent by use of Conebeam CT or 3D CT to study the elongated styloid process. Stylo-tonsillectomy is a safer approach with minimum complications and earlier relief of pre-operative symptoms. Surgical management with reduction of length of elongated styloid followed by adequate analgesia remains mainstay in treatment.