Improvement of methods of diagnosis the hypertrophy of the styloid process of the temporal bone and stylohyoid syndrome in an outpatient and polyclinic conditions using functional tests

Abstract

The Eagle's syndrome is a disease is caused by irritation of the nervous, vascular and muscular structures the surround the subcutaneous process of the temporal bone. A syndrome manifested by chronic pain at the deep part of the lateral region of the face, which irradiates in to the root of the tongue, pharynx and ear, dysphagia, symptoms of disorders of the circulation of the brain. Symptoms of Eagle’s syndrome are founding various otolaryngological, dental, neurological diseases. Aim: due to the lack of information on the development and course of the stylohyoid syndrome, conservative treatment and the complexity of diagnosis, the anatomical features of the hypertrophied styloid process, their length and angles of deviation and the need for local impact on the process, the stylohyoid ligament and the neurovascular bundle, to varying degrees presenting to the styloid process, it becomes necessary to develop the most effective and simple method for diagnosis a hypertrophied styloid process and to optimize the need for CT examination with contrasting of the great vessels of the neck and performing functional tests. Materials and methods: Over the past 9 years, we examined and treated 184 patients. The appeals were random, with no specific focus. Of these, there were 133 women (72.3%), men – 51 (27.7%); age – from 25 to 70 years old: 25-30 years old – 15 people (8.1%), 30-45 years old – 116 (63%), 45-60 years old – 38 (20.6%), 60-70 years old – 15 (8.1%); the duration of the disease is from 1 to 10-15 years. Our work was aimed at improving and simplifying the diagnosis of the hypertrophied styloid process during the initial treatment of the patient in an outpatient and polyclinic conditions using functional tests, determining the need to refer patients to CT examination to visualize the relationship of the elongated styloid process with the main vessels of the neck, the possibility of pressure of the append age on the vessels and nerves of the neck, both at rest and in the movement of the head and neck, the development of impaired blood circulation in the brain due to impaired blood flow through the arteries and impaired out flow through the veins, and the development of corresponding symptoms in addition to those described in the literature. Due to the difficulty of diagnosing hypertrophy of the styloid process of the temporal bone in an outpatient and polyclinic conditions and the lack of awareness of practical otolaryngologists about this problem, we proposed a scheme for examining patients with suspicion of this problem.