Symptomatic presentation of an enlarged, ossified triticeal cartilage

Abstract

(Editorial Comment: The reporters describe an unusual source of cervical pain; removal of the source resulted in symptomatic relief.) There are many reported cases of symptomatic stylohyoid ligament calcification or stylohyoid process elongation in the medical literature: however, similar reports that involve symptomatic enlargement or ossification of other infrahyoid musculature, ligaments, or cartilages are limited.’ Case reports of stylohyoid calcification include patients who present with symptoms of dysphagia, cervical and craniofacial pain, otalgia, ossification that mimics submandibular sialadenopathy, difficult intubation, and radiologically misdiagnosed foreign bodies. 2-5 Several researchers have investigated this process, and although symptomatic stylohyoid ossification is quite rare, asymptomatic ossification or elongation has been reported to be present in up to 40% of children and 84% of adults.“17 Eagle’s syndrome is a well-described condition of a post-traumatic, elongated, ossified styloid process or calcified stylohyoid ligament that results in dull cervical and facial pain secondary to a presumed compression of trigeminal or glossopharyngeal cranial nerves.6 This pain is often temporarily relieved by the injection of local anesthetic into the tonsillar fossa, and permanent relief may be obtained by resection of the involved calcified segments. Kehrl and Hartwein2 describe a series of syndromic patients with dysphagia and craniofacial or cervical pain who underwent either transoral or external resection of their