Ossification of Stylohyoid Ligament and its Clinical Significance: Case Report

Abstract

The styloid process, stylohyoid ligament, and the lesser horn of the hyoid bone form the stylohyoid chain which derives from the Reichert cartilage of the second brachial arch. Excessive or abnormal ossification of stylohyoid chain components may result in many variations which may be in the form of incomplete ossification, segmentation, pseudoarticulation and variations in thickness and angle, elongation of the styloid process. Abnormalities of stylohyoid chain may then compress or irritate nearby structures especially neurovascular structures i.e. carotid arteries, internal jugular vein and 7th 9th, 10th, 12th cranial nerves, leading to mild to severe symptoms, such as pain in throat, foreign body sensation in throat, cervico-facial pain etc. During routine dissection classes for MBBS, we reported two cases of ossification of stylohyoid ligament. In first case there was unilateral ossification of the stylohyoid complex and in second case there was a partial bilateral ossification of stylohyoid complex. Clinical symptoms of stylohyoid chain ossification vary from ear pain to dysphasia. It is important that clinicians should keep this entity in mind while considering the differential diagnosis of cervico-facial pain. Also, dentists, otolaryngologists and anesthetist are aware of the natural variations of the styloid process.