Abstract
Purpose:(1) To evaluate digital fracture of enlarged styloid as a clinical maneuver, in office setting, in relieving symptoms in stylalgia. (2) To avoid surgery or long term medications as definitive treatment of stylalgia. (3) To reduce the investigations, workload in OPD and thereby ultimately cutting the cost of health care.Methods: This study started with total relief of symptoms in a stylalgia patient instantaneously after incidental fracture of enlarged styloid process of the same side during routine clinical palpation. Encouraged with this we started this study; within the period from June 2008 to May 2010 total 36 patients were included in this study.Results: We had 36 cases with stylalgia, among them 4 cases had enlarged styloid so thick that they were resistant to digital fracture. Those 4 cases were taken for surgery. Among those four cases 3 (75%) were male. We found male styloid tougher and harder than that of females. We were able to fracture enlarged and symptomatic styloid in OPD in 32 cases. Among them after initial 1 hour, observation after the maneuver, 10 (31%) had complete of their symptoms and also 13 (40.6%) cases had considerable improvement of their symptoms within 1 hour, but 9 cases felt no improvement. We followed up our patients after, 1 week, 2 week, 1 month and 6 months. After 1 month, 26 had complete symptoms relief, 3 had considerable improvement and 3 felt no improvement. But after 6 months of follow-up, 2 cases with symptoms relieved completely, developed symptoms but with much lesser intensity.Conclusion: Using this simple in office procedure we were able to avoid long term medicines, recurrent investigations. By giving relief we could avoid surgeries in large majority of cases, making the already over burdened theater available to other patients and also cutting preoperative investigations. Thus we can cut the burden of health care for such chronic cases DOI:http://dx.doi.org/10.3329/bjo.v18i2.11990 Bangladesh J Otorhinolaryngol 2012; 18(2): 133-137
Highlights
Eagle’s syndrome symptoms may include facial pain, ear pain, dysphagia, voice change and a globus sensation that may cause frequent swallowing—these occurs secondary to elongation of styloid process— resulting compression and irritation of adjacent structures
We had 36 cases with stylalgia, among them 4 cases had enlarged styloid so thick that they were resistant to digital fracture
We can cut the burden of health care for such chronic cases
Summary
Eagle’s syndrome symptoms may include facial pain, ear pain, dysphagia, voice change and a globus sensation that may cause frequent swallowing—these occurs secondary to elongation of styloid process— resulting compression and irritation of adjacent structures. Eagle coined the term stylalgia to describe the pain associated with this abnormality[1]. Later Eagle described two types of the syndrome that come to bear his name (i) classic type. We found a big lacuna in world literature regarding data on stylalgia. Most of the authors have seen few cases each[2,3,4]. It is a rare disease and mostly under diagnosed[5]. Normal length of styloid process is 25-30mm[6,7,8,9], in about 4% of population it is enlarged[10]. Not in all cases of enlarged styloid there is stylalgia
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