Pulsed Radiofrequency Treatment in a Case of Eagle’s Syndrome

Abstract

Eagle (Arch Otolaryngol. 1937;25:584 and Arch Otolaryngol. 1949;49:490) first identified elongation of the styloid process and ossification of the stylohyoid ligament as a cause of orofacial pain. The elongated styloid process presses on the internal carotid artery and adjacent structures, including branches of the glossopharyngeal nerve and this produce orofacial pain. Some authors define an elongated styloid process as longer than 4 cm because this length is associated with an increase in the incidence of Eagle's syndrome. The syndrome is diagnosed by exclusion (Walkman SD. Atlas of Uncommon Pain Syndromes. Philadelphia: Elsevier Science; 2003), and the diagnosis is confirmed by radiological studies and computed tomography. Treatment can be divided into medical, interventional, and surgical techniques. We report a patient with symptoms of glossopharyngeal neuralgia, who was diagnosed with Eagle's syndrome on the basis of diagnostic imaging. The length of the stylohyoid process was 63 mm on the left side and 64 mm on the right. Treatment was performed by applying pulsed radiofrequency to the glossopharyngeal nerve with satisfactory results. The technique was performed twice on an outpatient basis, produced no complications or side effects, and proved effective in the short and medium term in decreasing the intensity of pain.