Of Eagle's Syndrome and Finding Some Clarity on Its Management.

Abstract

Eagle's Syndrome is a much discussed yet controversial and debatable diagnosis of exclusion which is treated by many specialities with often unsatisfactory results. Due to entrapment/impingement on surrounding neurovascular structures by elongated styloid process patient may present with multitude of symptoms. Treatment is controversial and opinions are divided on choice of conservative and surgical management. Aim was to study outcomes of conservative and surgical modalities of treatment of Eagle's Syndrome and bring some clarity on management, what to offer, to whom and when. This prospective observational descriptive study included 15 patients of Eagle's Syndrome, 7 were treated with conservative method and 8 underwent resection of styloid process with intraoral approach. With objectives in mind to study efficacy of both management modalities, pain visual analogue scale (VAS) scores were recorded pre-intervention, post-intervention and during follow up on 1, 3 and 6months and compared. Conservative management resulted in up to 70% reduction in pain VAS scores till 3months of therapy (mean pre-intervention score being 3.71, 3months-1, 6months-1.29), while surgical modality resulted in nearly 99% reduction in mean pain VAS scores up to 3months and even improved after 6months (mean pre-intervention score being 6.75, 3months-0.5, 6months-0.13). With this we can conclude that conservative management provide satisfactory short-term (up to 3months) results but recurrences are known, while surgical resection of elongated styloid process gives better long-term results (6months and beyond).