Length Of Styloid Process Research Articles

Eagles’ syndrome: is it the longest styloid process length to date? A case report and an overview of the literature

Eagle syndrome is a rare condition that occurs when the styloid process, a bony projection in the skull, becomes elongated and causes pain in the head, neck, and face. The causes of Eagle syndrome are not entirely clear, but it is believed to be related to a genetic predisposition or trauma to the head or neck. The most common symptoms of Eagle syndrome include a sharp pain in the throat or ear, difficulty swallowing, and a feeling of a foreign object in the throat. Other symptoms may include headaches, facial pain, and neck pain. Diagnosis of Eagle syndrome can be challenging as symptoms can be mistaken for other conditions such as myofascial pain syndromes, glossopharyngeal or trigeminal neuralgias, migraine and cervical arthritis. However, proper diagnosis can be established by performing adequate physical examination, taking clear medical history, and full workup including imaging tests such as X-rays, CT scans, or MRIs to confirm the diagnosis.

Outcomes of Elongated Styloid Process Syndrome Treated with Minimally Invasive Cervical Styloidectomy (MICS)-A Single-Center Retrospective Study.

Background: Stylohyoid syndrome, also known as classical Eagle syndrome (ES), is a rare condition characterized by elongation of the styloid process (SP) or calcification of the stylohyoid chain, presenting numerous non-specific symptoms. Most papers concerning this rare condition are case reports, case studies, or retrospective studies. This retrospective study delves into the intricacies of Eagle syndrome and evaluates surgical outcomes in patients treated with minimally invasive cervical styloidectomy (MICS). Methods: We conducted a retrospective study of patients treated due to ES between September 2021 and August 2023. Ninety-seven patients were qualified for MICS. Evaluation before and after surgical treatment was conducted during follow-up visits and by a questionnaire that included various data, such as symptoms, pain intensity, evaluation of healing period, and overall patient satisfaction. The minimum follow-up period was six months. Results: After applying inclusion and exclusion criteria, eighty-four patients were qualified for further assessment. The most common symptoms that subsided completely after treatment were pharyngeal foreign body sensation and pain with dysphagia or odynophagia. The MICS procedure proved to be highly effective, with 94.2% of patients experiencing a significant reduction in pain intensity and 97.1% reporting overall success. All patients were satisfied with the aesthetic outcome of the scar. The length of SP and time onset from the first symptoms to treatment positively correlated with the number, intensity, and time required for symptoms to subside. Conclusions: Eagle syndrome should be considered in diagnosing patients with orofacial and cervical pain symptoms, as the time from occurrence of the first symptoms to treatment is crucial. MICS is highly effective and has a low rate of complications in treating ES. Potential scar formation should not be a significant factor when deciding between the intraoral and external approaches.

Τhe styloid process length and the stylohyoid chain ossification affect its relationship with the carotid arteries

PurposeThe elongated styloid process (SP) is associated with internal carotid artery (ICA) dissection, due to its close relationship with the vessel. However, the relationship with the variable ossified stylohyoid chain (SHC) has been scarcely studied. The current study investigated the relationship between the temporal bone's SP and the external and internal carotid arteries (ECA and ICA). The hypothesis was that the morphological variants of the SP influence this relationship. MethodsSixty multidetector computed tomography angiographies (120 heminecks) were randomly selected and retrospectively analyzed. SP elongation and the degree of SHC ossification were assessed. The distances (mm) between the SP and the carotid arteries (CAs) were measured. ResultsElongated SPs were present in 21 patients (35%), while 18 patients (30%) exhibited variable degrees of SHC ossification. The mean distance from the SP tip and ECA was 5.45±3.01mm from the ECA and 6.16±3.11mm to the ICA. The minimum distance between SP and ECA was 3.96±2.74mm, and between SP and ICA was 4.72±2.73mm. A statistically significant reduction in SP-ICA distance was observed in cases with elongated SP and SHC ossification, while the SP-ECA distance was statistically significantly shorter in cases of SP elongation. Additionally, three novel topographical patterns between the SP and surrounding vascular structures were identified. ConclusionsSP elongation and variable SHC ossification may impact the spatial relationship between the SP and the ICA/ECA. The proximity of the SP to the carotid arteries, particularly the ICA, holds clinical significance, as a reduced distance may predispose patients to carotid artery dissection, increasing the risk of stroke.

Evaluation of styloid process elongation: a cross-sectional study

Aims: The styloid process is a cylindrical projection of the temporal bone. When the length of the styloid process exceeds 30 mm, it is considered elongated. The aim of this study was to investigate the length, thickness and morphological pattern of the styloid process of patients using panoramic radiography and to evaluate the relationship with age and gender. 
 Methods: The study is designed retrospective cross-sectional and consisted of 3012 panoramic radiographs from patients routinely referred within the last six months, in which the borders of the styloid process region were clearly visualised on radiographs. Age and gender data of the patients were recorded. Styloid process was evaluated in terms of length, thickness and Langeais classification. 
 Results: The mean age of the patients was 38.32 years. 34.4% (n:1156) were male and 61.6% (n:1856) were female. The mean styloid process length was >30 for 32% of the patients. The thickness of the right styloid process was 2.73±1.56 and that of the left styloid process was 2.69±1.5. The length of the styloid process ranged between 0-79.98 mm with a mean of 26.12±10.78 mm. Most of the patients were in Langeais Type 1 class in right and left styloid process. There was a statistically significant correlation between the length, thickness and Langeais classification of right and left styloid process (p

Morphometric Analysis of Distal End of Dry Human Radius in Northern India and Its Clinical Implications in Relation to Wrist Joint and Inferior Radioulnar Joint Arthroplasty: A Cross-sectional Study

Introduction: The lower end of the radius is involved in the formation of the wrist joint and inferior radioulnar joint. Its morphometry is crucial for surgical procedures related to wrist arthroplasty. Aim: To measure the various morphometric parameters of the distal end of the radius and the distal articular surface of the radius. Materials and Methods: The present cross-sectional study was conducted in the Department of Anatomy, Rohilkhand Medical College and Hospital, Bareilly, Uttar Pradesh, India, from April 2023 to July 2023. The following parameters were measured: Length (LR) and Weight of Radius (WR), Length of Styloid Process (L-SP), Anteroposterior Length (APL-UN), Height (H-UN) and Depth (D-UN) of Ulnar Notch, Transverse Width (TW-DR), Oblique Width (OW-DR) and Anteroposterior Diameter (APD- DR) of the Distal Radius, Dorsal Tubercle Distance from the styloid process (DTD-SP) and from the Ulnar Notch (DTD-UN), Anteroposterior Length (APL-SF) and Transverse Length (TL- SF) of Scaphoid Facet, Anteroposterior Length (APL-LF) and Transverse Length (TL-LF) of Lunate Facet, Radial Inclination (RI) and Palmar Tilt (PT). Statistical analysis was performed using International Business Machines (IBM) Statistical Package for the Social Sciences (SPSS) software version 22.0. The values of the right and left sides were compared with a Student’s t-test. Results: Various morphometric parameters were measured on 80 dry adult radii (44 right and 36 left). The mean LR was 23.27±2 cm, WR was 39.24±9.84 gm, and L-SP was 10.9±2.40 mm. APL-UN, H-UN and D-UN were 14.29±1.80 mm, 7.75±2.07 mm and 1.68±0.63 mm, respectively. TW-DR, OW-DR and APD-DR of the distal end of the radius were 27.22±3.55 mm, 29.17±3.09 mm and 18.29±2.36 mm, respectively. The mean DTD-SP and DTD-UN were 20.66±2.40 mm and 16.29±2.53 mm, respectively. Mean values of the scaphoid facet and lunate facet were 11.75±1.44 mm (APL-SF), 15.16±2.165 mm (TL-SF), and 15.96±1.92 mm (APL-LF), 10.20±1.52 mm (TL-LF), respectively. The mean angles of RI and PT were 24.48±5.06˚ and 10.91±3.179˚, respectively. No significant difference was found between the right and left side values (p-value>0.05). Among the 80 radii, 43.8% had four grooves, 42.5% had three grooves, and 13.8% had only two grooves present on the dorsal surface of the lower end of the radius. Out of 262 observed grooves in 80 radii, 50 (19.09%) were vertical and 212 (80.91%) were oblique. The groove medial to the dorsal tubercle was oblique in 70 (87.5%) radii and vertical in 10 (12.5%) radii. A highly positive correlation was found between the oblique and transverse width of the distal radius (r-value=0.74 and p-value=0.01). Conclusion: The present study found no significant difference between the values of the right and left sides. The parameters identified may assist surgeons in selecting the appropriate size of the prosthesis or in corrective surgeries related to the lower end of the radius.

Evaluation of Styloid Process Length and Calcification Degrees of Renal Transplant Patients with Panoramic Radiographs

Purpose: The aim of this study was to evaluate the styloid process length and calcification degrees of renal-transplant patients and compare them with the healthy control group. Materials & Methods: Panoramic radiographs of 93 patients who had renal transplantation and 93 healthy patients were reviewed retrospectively. Length measurements were made from the apex to the base of the styloid process with a line following the profile. The elongation degrees were classified into five groups as normal (type 0), elongated (Type 1), pseudo-segmented (Type 2), segmented (Type 3) and non-continuous (Type 4). Calcification degrees were classified into four different groups as external (Type A), partial (Type B), nodular (Type C) and complete calcification (Type D). Results: The study and control groups were matched for age and gender. Styloid process length was found to be significantly higher in male than in female (p<0.001). The extent of elongation and calcification did not differ in terms of gender. The mean styloid process length values were found to be significantly higher in the study group compared to the control group (p<0.001). There was a significant difference between the groups in terms of elongation degrees (p<0.001). For elongation types, while the majority of the study group was type 1, type 0 was observed more in the control group. No difference was observed between the groups in terms of the calcification degrees (p=0.076). Conclusion: Changes in phosphate balance and parathyroid hormone levels, possibly due to hemodialysis treatment in renal transplant patients, may have led to styloid process elongation.

Artificial Intelligence: A Reliable Tool to Detect the Elongation of the Styloid Process.

Background Eagle's syndrome is characterized by the anomalous elongation of the styloid process. This condition is usually identified through the manual evaluation of orthopantomogram (OPG) images, which is time-consuming and can have interobserver variability. The application of Artificial intelligence (AI) in radiology is gaining importance and interest in recent years. The application of AI in detecting styloid process elongation is less explored, advocating for research in the same arena. Aim and objectives The study aimed to evaluate the accuracy of artificial intelligence in detecting styloid process elongation in digital OPGs and to compare the performance of the three different AI algorithms with that of the manual radiographic evaluation by the radiologist. Materials and methods A total of 400 digital OPGs were screened, and linear measurements of the styloid process length (ImageJ software (National Institute of Health, Maryland, USA)) were done for the identification of styloid process elongation by a single calibrated observer to finally include a processed image dataset including 169 images of the elongated styloid process and 200 images of the normal styloid process.A machine learning approach was used to detect the styloid process elongation using the three different AI models: logistic regression, neural network, and Naïve Bayes algorithms in Orange software (University of Ljubljana, Slovenia). Performance evaluation was done using the accuracy, sensitivity, specificity, precision, recall, F1 score, and AUC-ROC (area under the receiver operating characteristic) curve. Results Logistic regression and neural network algorithms depicted the highest accuracy of 100% with no false positives or false negatives, securing a score of 1.000 for all the metrics.However, the Naïve Bayes model demonstrated a fairly considerable accuracy, classifying 49 false positive images and 59 false negative images with an AUC (area under the curve) score of 78 %. Nevertheless, it performed better than random guessing. Conclusion Logistic regression and neural network algorithms accurately detected styloid process elongation similar to that of manual radiographic evaluation. The Naïve Bayes algorithm did not perform an accurate classification yet performed better than random guessing. AI holds a promising scope for its application in automatically detecting styloid process elongation in digital OPGs.

Prevalence of elongated styloid process on cone-beam computed tomographic images: a retrospective study

Aims: The aim of the study was to evaluate the prevalence and the morphometric features of the styloid process (SP) via cone-beam computed tomography (CBCT). Methods: 400 SP of 200 individuals (92 males, 108 females, age range 12-81) were examined retrospectively in CBCT images in the axial, sagittal, and coronal planes. The measurements of SP and clinical and incidental findings associated with styloid ligament elongation (ESP) were detected. For descriptive statistics, the mean and standard deviation are given for numerical variables. The Mann-Whitney U test was used for measurements. The consistency of right and left SP lengths was analyzed for normality using the Shapiro-Wilk test (p<0.05). Results: Males (55.7%) had a substantially higher prevalence of ESP than females (33.1%) (p = 0.032). On the right side of the SP, the mean length was 26,76 mm (range: 8,7–63,3 mm), while on the left, it was 26,61 mm (range: 5,8–55,9 mm). 51 of them had bilateral lengths greater than 30 mm. The eight symptomatic patients' CBCT scans revealed SP sized anywhere from 36,6 mm to 69 mm on the right side. As incidental findings, soft tissue calsifications were detected in 5% of the 200 patients. Conclusion: Three-dimensional imaging to identify SPE and also possible soft tissue calcifications in the maxillofacial region has a significant impact in cases with or without symptoms.

Management of eagle syndrome.

Eagle syndrome is a challenging clinical presentation with important potential complications. It can be misdiagnosed due to lack of awareness; this review provides information in terms of diagnosis and management of eagle syndrome. The importance of early diagnosis of this rare disease is preventing the delay in clinical-surgical treatment. As there is not a universally accepted cut-off for styloid process length, the diagnosis should be confirmed by length of process greater than one-third of the length of mandibular ramus in addition to other clinical symptoms and signs. There are both surgical and pharmacological treatment options for these patients. Eagle syndrome is a rare clinical condition and its diagnosis is made by physical examination and radiography. When it is suspected by physical examination, definitive diagnosis is confirmed by computed tomography scans of the skull, as the gold standard. Location, degree of elongation of styloid process, and severity and reproducibility of symptoms are important factors in deciding the most appropriate approach. Surgery is frequently the treatment of choice in Eagle syndrome patients. With proper diagnosis and treatment, the prognosis is favourable and recurrence is uncommon.

Evaluation of alterations in length and calcification of the styloid process in patients with end-stage renal failure

This study compared alterations in length and types of elongation and calcification of the styloid process (SP) between patients with end-stage renal failure (ESRF) who received renal transplantation, patients with ESRF undergoing dialysis, and a healthy control group. The SPs of 58 patients who had undergone renal transplants, 58 patients who received dialysis treatment, and 58 healthy individuals were examined with panoramic radiographs. Length measurements were made from the apex to the base of the SP. Elongation types were classified into 5 groups: normal, non-segmented, pseudo-segmented, segmented, and non-continuous. Calcification types were classified into 4 groups: external, partial, nodular, and complete. SP length was significantly greater in the renal transplantation and dialysis groups than in the control group (P < .001) and significantly longer in the renal transplantation group than in the dialysis group (P < .001). There was a significant difference between the groups regarding elongation types (P < .001), with the non-segmented type more frequent in the dialysis and renal transplant groups than in the control group. There was no significant difference in calcification types between groups (P=.225). Elongation and calcification types differed between sexes (P ≤ .008) CONCLUSIONS: Orofacial pain complaints in patients with ESRF should raise the suspicion of abnormal elongation and calcification of the SP, perhaps a manifestation of Eagle syndrome. It would be useful to evaluate the SPs of these patients clinically and radiographically.

Assessment of Anatomical Variation of Styloid Process in Multidetector Computed Tomography

Objective: This study aimed to assess the anatomical variation of the styloid process of Nepalese individuals by using multi-detector computed tomography scans. It was carried out to establish the baseline for the normal length of the styloid process and to compare the variability of styloid process measurement between different age group and gender. Materials and methods: This quantitative, cross-sectional was performed in the Department of Radiology and Imaging, Tribhuvan University Teaching Hospital. Imaging data were collected over the period of January to April 2021 with the total number of 153 individuals. The age and gender of the individuals were noted. The measurement was done in the Multiplanar Reconstruction (MPR) coronal sections of Head and Neck, PNS and Cerebral Angiography. Various Styloid Process (SP) morphology parameters like RLSP, RGSP, LLSP, LGSP, Right Elongation Type, Right Calcification Type, Left Elongation Type, and Left Calcification Type was measured. Results: The measurement of the length of SP was found to be 3.06±0.72 cm (ranged 1.80-5.54 cm) in right SP while that of left SP was 3.08±0.72 cm (ranged 1.45-5.69 cm). The gap between the SP and the calcification pattern was found to be 0.51±0.30 cm (ranged 0.08-1.20 cm) in right SP while that of left SP was 0.63±0.43 cm (ranged 0.08- 1.97cm). Similarly, there was a statistical significant difference between the RLSP-RGSP and LLSP-LGSP. The length of styloid process was found to be higher among male than in female. But there was no statistical significant difference between male and female in the SP measurement. The series of elongation patterns were found to be normal SP, followed by elongated, distant elongated, pseudoarticulated, and segmented SP. The series of calcification patterns were found to be calcified SP, followed by nodular, partial, and outlined SP. Conclusion: In this study, the valuable information regarding anatomical length and variation of styloid process with respect to age and gender among the Nepalese individuals was found. 3D CT reconstruction is a gold standard investigation that helps in studying the relation of the SP with surrounding structures.

Measurement of bony anatomical parameters of the distal ulna based on healthy adult data: A cross-sectional study.

This study sought to conduct several three-dimensional measurements of the distal ulna in healthy Han Chinese, providing the anatomical basis for the diagnosis and treatment of hand trauma, distal ulnar disorders, and the design of wrist prostheses. 50 Han Chinese men and women that underwent computed tomography (CT) scans of the distal ulnar carpus were included in the present study. A three-dimensional digital model of the distal ulna was reconstructed using Mimics software. Moreover, the anatomical data of 10 indicators were measured using MIMICS software. Each index data was measured by 2 investigators independently, and the average value was taken. The data were stratified and compared between left and right sides and men and women. A 3D digital model of the distal ulnar bone with a realistic shape was reconstructed. The 10 anatomical parameters measured are as follows: The length of the ulnar styloid process (posterior anterior), The length of the ulnar styloid process(anterior and posterior); the transverse diameter of the ulnar head; the anteroposterior diameter of the ulnar head. The radial inclination angle of the ulna; the ulnar inclination angle; the distal space between the ulna and radius; the ulnar notch angle of the lower radius. The anterior and posterior diameters of the ulnar notch of the lower radius, and the superior and inferior diameters of the ulnar notch of the lower radius. Statistical analysis showed no significant difference after stratification by laterality and gender. our findings can providing the anatomical basis for the diagnosis and treatment of hand trauma, distal ulnar disorders and further improve currently available wrist joint prostheses. Observational, Cross-sectional study, LOE: Level II.

Evaluation of Styloid Process Length using Multidetector Computed Tomography Scan in Indian Population: A Cross-sectional Study

Introduction: The length of the Styloid Process (SP) has been a subject of research since Eagle's case report on a syndrome characterised by symptoms related to a painful elongated SP. Various modalities including orthopantomogram, digital radiography, cadaveric measurements, and Multidetector Computerised Tomography (MDCT) scanning have been used to study SP length. The present study aims to determine the normal SP length in the Indian population, specifically among armed forces personnel, using MDCT scans. Aim: To measure the SP length in the Indian population using MDCT scans and establish a cut-off length to define elongation. Materials and Methods: A single centre cross-sectional study was conducted at the Department of Radiology, Command Hospital Pune, Maharashtra, India from January 2023 to March 2023. The SP length was measured in 402 patients referred for CT scans of the head and Paranasal Sinus (PNS), utilising 3D Multiplanar Reformation (MPR), curved reformat, and volume rendering techniques. The patients were divided into six age groups: Group I (&lt;20 years), Group II (21 to 30 years), Group III (31 to 40 years), Group IV (41 to 50 years), Group V (51-60 years), and Group VI (&gt;60 years). Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) Version 28.0, and significance was set at p-value &lt;0.05. Results: Among the 402 patients, 210 were males, and 192 were females, with a mean age of 43.8±16.7 years. The mean SP length across all patients was 23.24±3.92 mm. The mean length was 23.74±4.50 mm on the right side and 22.74±3.72 mm on the left side, with no statistically significant difference between them (p-value=0.058). There was a significant gender difference, with males having a mean length of 23.67±4.12 mm and females 22.77±3.64 mm (p-value=0.011). The SP length increased significantly with age, demonstrating a notable difference between age groups. The upper limit of normal (90th percentile) ranged from 25.74 mm for patients &lt;20 years to 28.91 mm for patients &gt;60 years. Conclusion: A statistically significant difference in SP length was observed between genders, with a significant increase in length with age. In the Indian population, an SP length greater than 28 mm should be considered elongated.

A Review of Eagle’s Syndrome

Eagle’s syndrome results from a calcified corresponding impact ligament or an elongated styloid process (ES). Neck or throat pain with ipsilateral ear radiation are other symptoms. Symptoms may be mistaken for facial neuralgias. Radiological and physical examinations may diagnose ES. ES is treated surgically. Intraoral or external procedures shorten the styloid process. The primary goal of this research was to investigate all aspects of Eagle’s syndrome that might be significant to its care and prognosis. In this study, we have used secondary research approach. In this paper, we analyzed several papers and articles to comprehensively review the Eagle’s syndrome. Our study demonstrates that an expanded styloid process isn't usually a sign of Eagle’s syndrome. Depending on the etiology, a prominent lateral misconfiguration can induce anything from a little cervicofacial irritation to deadly ischemic damage. The symptoms were caused by the styloid process's length and anterior angulation, not its medial angulation. Keywords: Eagle’s syndrome, elongated styloid, pain, sensation, treatment.

Possible influence of styloid process length on isolated vertigo of unknown aetiology

ObjectiveEagle syndrome or styloid process syndrome is a clinical condition of complex aetiology. Since, as a consequence of vascular compression,due to the length of the styloid process and its nearness to the internal carotid artery,it can lead to vertigo. Vertigo may be the only symptom of stylocarotid syndrome and it is extremely challenging diagnose.To the best of our knowledge, this is the first study that measures the lengths of styloid process on the Croatian population's,and possible influence of styloid process length on isolated vertigo of unknown aetiology. MethodsThis study included 829 subjects who were divided into two groups.The first group was the control group, consisting of 800 subjects.The second group, study group, consisted of 29 subjects who suffered from the vertigo of unknown aetiology. ResultsThe statistically significant difference between the study and the control group was observed in the length of the styloid process, and in the closest distance of the styloid process from the carotid artery. ConclusionsThe prolonged styloid process and its close association with the internal carotid artery may affect vertigo of unknown aetiology and should be clinically and radiographically investigated in cases of unexplained vertigo as an isolated and only symptom within stylocarotid syndrome.

Eagle jugular syndrome: a morphometric computed study on styloid process orientation

Cerebral venous drainage impairment is related to a wide spectrum of pathologies, both acute or chronic. Among the most intriguing and less explained there are those caused by a long-lasting compression on internal jugular vein (IJV), mono or bilaterally. Recently, a jugular variant of the Eagle syndrome has been described,1,2 in which an elongated styloid process, coming from the mastoid tip down through the neck, compresses the IJV (more frequently J3) in its passage on the C1 anterior arch. Interestingly, those patients often complaint of typical symptoms of intracranial hypertension, such as headache (not frequent in classic Eagle syndrome), tinnitus, dizziness. They also seem to have an increased risk of perimesencephalic hemorrhages. Conceptually, it is not the styloid process length in itself to determine the compression, but rather its spatial orientation. We could therefore expect to find patients suffering from Eagle jugular syndrome who present normal or short styloid process, but in close proximity to C1. To test this hypothesis, we are developing a novel software to analyze 3-D spatial orientation of styloid process in patient with a previously diagnosed Eagle jugular syndrome compared to healthy controls. Methods We collected cervical computed tomography angiography (CTA) images from 8 patients with EJS confirmed by venous angiography at our institution, and a control group of 7 random patients, homogenous for sex and age. A blind operator created with a dedicated pre-existing software3, an editable 3-D model (.stl file) of the 3 main region of interest (ROI), namely: right styloid, left styloid, C1 anterior arch. Starting from this dataset, our software, written using the open-source package management system Anaconda4 ver. 2-2.4.0, compares all the possible couples of points between each styloid process and the C1 arch, detecting the minimum and maximum distance. Then, it provides the mean spatial orientation of the process respect the CT-axis: x-axis (from left to right), y-axis (from occiput to nose) and z-axis (cranio-caudal). Results By now we included 15 patients (8 cases, 7 controls), homogeneous for sex and age. Preliminary data (Table 1), although not statistically significant yet, seems to indicate that Eagle jugular patients effectively have a more vertical styloid process, meaning an angle between styloid and y-axis greater than controls, rather than a longer one. Conclusions Our preliminary results could confirm that spatial orientation is more important in Eagle jugular patients than styloid process length. This study is currently ongoing and we planned to enroll at least 20 subjects for each arm. At the same time, we are collecting data from patients with carotic variant of Eagle syndrome, to better characterize morphometric structure of styloid in various subset of this pathology.

Styloid Process Length Variations: An Osteological Study.

The objective of this study was to study the morphometry of the styloid process of the temporal bone and the prevalence of an elongated styloid process in relation to side and gender. The present study included 200 human skulls which were procured from the rich osteological collections of the Department of Anatomy, Faculty of Medicine, University of Sarajevo. The styloid process was observed macroscopically on both sides of all the skulls and elongations, if any, were noted. The lengths of the styloid processes were measured using digital vernier calipers. The measurements were taken from the point of emergence of the process (base) up to the tip. Out of 200 specimens, only 14 cases (7%) exhibited an elongated styloid process. The mean length of the styloid process was 25.8±4.68 mm and 24.2±4.54 mm for the right and left sides, respectively. The size of the styloid process did not different significantly between the two sides (P=0.724). The mean length of the styloid process was 24.05±3.54 mm in females and 25.95±5.68 mm in males, and the difference was statistically significant (P=0.023). The study and knowledge of the anatomical variations of the styloid process in the Bosnian population may help clinicians to diagnose Eagle's syndrome. Knowledge of this disorder can prevent the worsening of the painful symptoms related to an elongated styloid process.

A gross anatomical study of the styloid process of the temporal bone in Japanese cadavers.

The incidence of an elongated styloid process (SP) and average length and diameter of SP have not been reported using Japanese cadavers. Data on the female-to-male ratio of an elongated SP vary. We calculated the average length and diameter of SP in Japanese cadavers and compared SP lengths between sexes. Twenty-seven sides (right and left of bodies) in males and 51 sides in females were analysed. Measurements were obtained from the inferior external acoustic meatus to the distal tip of the SP. SP diameters at the proximal base, midpoint, and distal tip were measured. SP > 30 mm was considered elongated. We used Welch's t-test for the statistical analysis. Fisher's exact two-tailed test was also performed to analyse the female-to-male elongation ratio. A p-value < 0.05 was considered statistically significant. Styloid process elongation prevalence was 29.5% in our sample. The average full length was 27.04 ± 7.88 mm overall; the average diameters were 5.41 ± 1.77 mm at the proximal base and 2.21 ± 1.22 mm at the distal tip. The average SP measurement was 26.81 ± 5.92 mm in males and 27.16 ± 8.79 mm in females (p = 0.74). The female-to-male ratio of SP elongation was 1:2 (p = 0.041). Females had longer full lengths of non-elongated SPs than males (p = 0.004). Males had wider diameters at the proximal base of elongated SPs than females (p = 0.017). The average length of SP was 27.04 mm in the Japanese population and about 30% of the Japanese presented SP ≥ 30 mm. Male had significantly higher rate than female among the SP ≥ 30 mm, and female had significantly longer SPs than male among the SP < 30 mm. Anatomically, the SP gets narrow as distally goes. Our anatomical findings would be beneficial to creating treatment plans, diagnosis, and surgery.

MORPHOMETRIC STUDY OF THE STYLOID PROCESS AND ITS CLINICAL IMPLICATIONS

Background: Styloid process is a slender, cylindrical spur of bone fused with the inferior aspect of the temporal bone in front of the stylomastoid foramen. Present study aimed to evaluate the length, angulation, interstyloid distance and styloid ratio to highlight their possible etiological importance in clinical and surgical conditions. Interstyloid distance is used for sexual dimorphism. Excessive length and angulation of styloid process is clinically important, as it may cause Eagle's syndrome. Material And Methods: The study was done on both sides of 52 dry human skulls of unknown age and sex without any obvious deformity. Each skull was carefully examined for the presence of elongated styloid process (length&gt;30 mm). The length was measured using Vernier caliper and interstyloid distance was measured using divider. Angle of styloid process with the Reid's baseline and styloid ratio was also calculated. Results: Out of 52 skulls, elongated styloid process was observed in thirteen skulls, amongst them eight skulls (15.38%) with unilateral and ve (9.62%) with bilateral elongation. Rest of the skulls (n=39) had lengths varying from 20-30 mm. Mean angle between styloid process and Reid's baseline was 51.13°. Average interstyloid distance was 75.42 mm while 70-80 mm was the most common range. Styloid ratio varied from 3-4. Conclusions: Unilateral elongated styloid process was found more frequently as compared to bilateral. The results can be used as a baseline data for identication of male and female skull by calculating the interstyloid distance. The ndings of the present study may be of utmost importance in the examination of styloid process in patients with symptoms of stylalgia.

Elongated styloid process: literature review and morphometric data on a collection of dried skulls

The styloid process is a subtle process of variable length that originates from the petrous part of temporal bone . From the process originate three muscles: the stylopharyngeus,the styloglossus, the stylohyoideus and two ligaments :stylohyoid and stylomandibular . The styled process of the temporal bone has a variable length as demonstrated for studies conducted in three-dimensional computed tomography or dental panoramic three-dimensional scanning,and in dried skulls The normal length of the styloid process is particularly important to establish for the relations of closeness with vascular and nervous structures and their possible compression by an elongated styloid process.Several studies have focused on the effects of changes in length and course of the styloid process, highlighting the relations of the carotid artery and the glossopharyngeal nerve to explain cerebrovascular symptoms or Eagle’s syndrome characterized by neck pain and dysphagia .However the association for the abnormal length of styloid process and Eagle’s syndrome is not always present and many cases are asymptomatic. In the present study we propose a review of the studies performed with different in vivo radiological techniques and on dried skull collections on the normal and pathological length of the stiloyd process and on its association with the Eagle’s syndrome. We also present a morphometric study carried out in dried skulls of our museum collection.The results are discussed in light of the possible variations in the muscular and ligamentous structures consequent to the elongation of the styloid process.