Left Styloid Process Research Articles

Stylocarotid syndrome: A case report

The American otolaryngologist Eagle was the first to describe styloid syndrome in 1937 and the syndrome was named after him (Eagle's syndrome). The original description of two separate syndromes is connected with his name: classical syndrome, which almost constantly occurs after tonsillectomy and carotid artery syndrome, which occurs without tonsillectomy and also in cases when stylohyoid complex compresses the carotid segments and perivascular sympathetic fibers. In the following years, two more syndromes were defined: stylohyoid and pseudostylohyoid, which according to their manifestations, correspond to the genuine classical form. A 40-year-old male is presented, with a history of 3-year duration of pains in the upper part of the left side of the neck, in the left eye and its surroundings. Pain occurrences were not regular. Throbbing pains were most often provoked by sudden head movements and neck compression. He was healthy until the onset of these problems. The findings of all examinations were normal. The applied prophylactic therapy, typical for cluster headache, was without any effect. On 64-MSCT (multislice computed tomography), the neck arteries did not show any intraluminal pathology. The styloid processes were of normal length. On the left side, the styloid process tip pressed the internal carotid artery disturbing its longitudinal axis. In our presentation, the defined lengths of the styloid processes were normal. The medial angulation of the left styloid process was more expressed reaching 63.5 degrees (the right side angulation was normal). Persistent and throbbing pain in the region of the left eye with backward projection suggested compression on the internal carotid artery. Pains were most frequently provoked by head turning and neck compression. 64-MSCT diagnostics enabled us to determine the characteristics of styloid processes and their relation to the internal carotid artery. Improvement was achieved by administration of antiepileptic (gabapentin) and antidepressant (amitriptyline) drugs.

First‐Bite Syndrome After Resection of the Styloid Process

First-bite syndrome (FBS) may occur after operations on parapharyngeal space. The main symptom is excruciating pain only after the first one or two bites of meals. The objective of this article is to report a case of FBS after resection of the styloid process (SP). This 51-year-old woman had a 4-month history of pain on her left neck. Computed tomography scan showed a left hypertrophic SP. A diagnosis of Eagle syndrome (ES) was then established. She underwent excision of the left SP through a lateral cervicotomy. Postoperative recovery was uneventful with pain relief. However, 2 months postoperatively, intense pain appeared related to the first bite in every meal. She received 800 mg carbamazepine per day with good pain control. Medication was discontinued after 2 years with no further relapse. This is the first report on FBS after surgical treatment of ES. It is important to remember the possibility of the diagnosis and to maintain the patient under heavy specific medication, sometimes for longer periods.

茎状突起骨折によると推察されためまいの症例

Since he received a stranglehold during a judo bout, the patient had experienced repeated episodes of paroxysmal vertigo. The patient was a 16-year-old male with a chief complaint of horizontal oscillating vision. Plain X-ray examination during the initial consultation did not show a definite fracture of the styloid process. Balance testing disclosed no significant finding. Helical scan CT delineated a fracture in the center of the left styloid process and anterior deviation of the fractured segment.The mechanisms of oscillopia in this patient were considered to be the following; 1) the fractured segment of the styloid process stimulated the tensor muscle of the velum palatini causing a spasm, and induces symptoms of the inner ear, which is similar to the mechanism of Costen syndrome. 2) the fractured segment stimulated the autonomic nerves near the carotid artery, especially the vagal nerve when he raised his head, and induces transient hypotension, which caused an ischemic brain stem lesion.The present case was an extremely rare case involving a fracture of the styloid process with paroxysmal vertigo.

巨大な茎状突起過長症の一例

We recently experienced a patient complaining of sore throat and headache due to an elongated styloid process. Styloidectomy was performed with a good outcome. We describe this case briefly with review of the literature.A 30-year-old man had a sore throat and headache. A bone-like process was palpable in his left tonsillar fossa. The X-ray film revealed that his left styloid process abnormally extended to the lower inside, and the styloid process measured 90 mm. Under a diagnosis of elongated styloid process, styloidectomy was performed.After operation, his complaint disappeared completely. About 1 year after the operation, he remained symptomless without any recurrence.

茎状突起過長症の１症例

We encountered a patient whose chief complaint was swallowing pain due to elongated styloid process.We describe a report of this case with some discussion. The patient was 51-year-old male who visited our hospital with chief complaint of swallowing pain.Clinical examination of the oral cavity showed slight redness mucosa of the left tonsillar fossa.The X-ray film showed the left styloid process abnormally elongated, the tip of which extended to the mandiblar angle.Under a clinical diagnosis of the elongated styloid process, this process was removed by a intraoral approach. Whithin 1 week after operation, swallowing pain disappered.Recently the incidence of laryngo-pharyngeal neurosis is increasing, and it should be kept in mind that an elongated styloid process is not rare. In the diagnosis of this abnormality, orthopantomography seems to be better than another radiography.

Portion of Left Styloid Process

Portion of Left Styloid Process