Styloid process elongation or stylohyoid ligament calcification is not necessarily a predictor of Eagle's Syndrome

Abstract

The temporal styloid process (TSP) has close anatomical relationships with the internal jugular vein, internal carotid artery, as well as the facial, glossopharyngeal, vagus, and hypoglossal nerves. Elongation of the TSP or calcification of the stylohyoid ligament (SL), may lead to compression of the surrounding structures, resulting in symptoms typical of Eagle's syndrome. These symptoms include dysphagia, odynophagia, unilateral face and neck pain, transient ischemic accident, and cerebrovascular accident. The average TSP is approximately 2.5 cm in length, with a length greater than 3 cm being considered elongated. This study discusses two cadaveric specimens with TSP elongation or SL calcification, neither of which displayed symptoms of Eagle's syndrome in life. The relatives of each specimen were contacted to determine whether symptoms were present. Case one, a 71‐year‐old male, was found to have bilateral calcification of the SL (right 88.18 mm, left 57.21 mm). The complete absence of symptoms was potentially due to the mobility of a pseudojoint attaching the calcified SL to the TSP. Case two, a 74‐year‐old male, displayed a right unilateral elongation of the TSP (48.74 mm). These two cases suggest that the degree of TSP elongation or SL calcification does not necessarily predict which patients will develop Eagle's syndrome.