Length Of Styloid Process Research Articles

Styloid Process Elongation, Shape and Calcification Pattern According to Age and Gender

Background: Styloid process (SP) is a slender pointed part of the temporal bone, which is closely related to the stylomastoid foramen. As many important neurovascular structures located near the tip of SP, the elongation or ossification of stylohyoid ligament may be associated with pain related to orofacial region known as Eagle’s syndrome. Aim of this study was to assess the prevalence of elongated SP, its morphology and calcification pattern on digital panoramic radiographs in patients attending the dental clinic of the University of Benghazi. Material and Methods: The digital panoramic radiographs with visible styloid processes of the studied group of patients were studied for their visibility, length and pattern of calcification. The length of styloid processes was measured in the radiograph and was considered elongated if that length exceeded 30 mm. The prevalence and pattern of elongation and calcification were determined according to Langlais classification. Results: Out of the 304 patients (164 are males and 140 are females) examined radiographically, the elongation of SP was detected in 156 (51.31%) of the patients. It was bilateral in 151 (96.79%) cases. There were no significant differences between males and females in regard to the length and shape of SP between in all age groups in both sexes, but the calcification pattern was significantly different between the age groups in both sexes. The outlined pattern of calcification of SP was the most prevalent especially in the younger age group (10-19 years), while the complete calcification pattern was most commonly detected in the older age group (≥ 60 years). Conclusion: elongated SP whether it is accompanied by pain symptoms or asymptomatic, can easily be detected on a digital panoramic radiograph and should be considered in the differential diagnosis of orofacial pain.

Eagle syndrome- An underdiagnosed diagnosis

Eagle syndrome occurs when an elongated styloid process or calcified stylohyoid ligament causes recurrent throat pain or foreign body sensation, dysphagia, or facial pain. Diagnosis is usually made on physical examination by digital palpation of styloid process in tonsillar fossa.To study the significance of chronic throat pain and elongated styloid process. 60 patients with chronic throat pain (excluding other causes) were assessed by palpation of styloid process was recorded according to age, gender of patients. The prevalence of elongated styloid process in age groups and gender determined correlation and significance of chronic throat pain, along with palpable styloid process in tonsillar fossa and length of styloid process in tonsillar fossa and length of styloid process was determined..The maximum number of patients having chronic throat pain were between 40-49 years age group. The male to female ratio was 0.62:1. The prevalence of elongated styloid process was seen more in 50-70 years of age. There was a higher prevalence of elongated styloid process with moderate to severe pain. 76% patients with elongated styloid process had tonsillar fossa tenderness. 96.4% of patients with elongated styloid process had palpable styloid process in tonsillar fossa. There is a significant correlation between patients having chronic throat pain and elongated styloid process. X ray Skull-Towne’s view is very cost effective as a baseline radiological investigation to diagnose elongated styloid process in patients with chronic throat pain for which cause is unknown.

Cervico-facial pain associated with Eagle's syndrome misdiagnosed as cranio-mandibular disorders. A retrospective study

Aim of studya retrospective study was done to assess symptoms correlated with and responsible for the misdiagnosis of Eagle's syndrome with Cranio-Mandibular Disorders. Materials and methodsOur study comprised patients suffering from vague craniofacial pain resulting from elongated styloid processes, presented to the outpatient clinic of the oral and maxillofacial surgery department, October 6 University Hospital. The length of styloid processes was measured on 3D-CT X-rays. All our patients were operated by surgical treatment in the form of shortening of the styloid process (styloidectomy) under general anaesthesia and followed up clinically as well as radiographically for 12 months. ResultsPatients were assessed preoperatively as well as postoperatively throughout the following scheduled regular follow up intervals at 1 week and at 1,3,6 and 12 months postoperatively for the following parameters. VAS pain score gradually decreased from a median of 9, with a minimum of 7 and a maximum of 10 pre-operatively to a median of 1.5, with a minimum of 0 and a maximum of 3 at twelve months. Freidman test revealed a statistically significant difference by time. Maximum unassisted mouth opening was assessed. Mouth opening significantly decreased from 30.23 ± 3.28 pre-operatively to 26.08 ± 2.83 after one week, then gradually increased to reach its highest level (43.56 ± 0.72) at twelve months. ConclusionWhen dealing with cases of vague craniofacial pain, possibility of Eagle syndrome should be considered.

Evaluation of styloid chain calcification related to temporomandibular joint disc displacement: a retrospective cohort study.

The present study aimed to evaluate any relationship between elongated styloid process (ESP) and temporomandibular joint disc displacement (TMJD). A retrospective cohort study. Dentomaxillofacial Radiology division of Erciyes University Dental Hospital. Ninety-four temporomandibular joints (TMJs) of 47 patients were allocated in this study. Intervention-disease: Two experienced dentomaxillofacial radiologists have interpreted all CBCT and MR images. Patients who referred with TMJ disorders were classified according to temporomandibular joint's disc status as normal disc position (ND), displacement with reduction (DWR) and displacement without reduction (DWoR). Main outcome measures: Interpretation of styloid chain calcification pattern and styloid processes length measured linearly on reconstructed sagittal slices of CBCT. Randomization: Cone beam computed tomography (CBCT) and magnetic resonance (MR) images of 154 patients who were admitted between September 1, 2012 and September 1, 2019. Only 47 of them fulfilled the study requirements. Blinding: Single blind of the outcome measurements and interpretations of MR images. Total 94 TMJs of 47 patients disc status groups were analyzed and defined as DWoR (n = 25), DWR (n = 32), and ND (n = 37). On multivariate analysis, no statistical significant differences were found between groups in terms of styloid process lengths. Mean SP length and standard deviation of disc status groups (DWoR, DWR, and ND) are 35.5 (± 9.8)mm, 34.6 (± 9.2)mm, and 38.3 (± 8.9)mm, respectively. When patients were grouped individually according to their post-MRI diagnosis, the mean styloid process length in the non-temporomandibular joint disc displacement (non-TMJD) patients (47.9 ± 10.8) was significantly higher than the TMJD patients (36.1 ± 9.3). In this study, there is no intervention to cause any harm or side effects. Our results indicate that styloid-stylohyoid syndrome may be misdiagnosed with temporomandibular joint disorder (TMD). Clinical Trials NCT04280107.

Evaluation of stylohyoid complex in subjects with different types of malocclusions using cone-beam computed tomography: a retrospective study in a Turkish subpopulation.

According to the functional matrix theory, the development of maxillomandibular complex may be affected by the surrounding tissues. The aim of this study was to evaluate the length and angulation of the styloid process in different types of malocclusions using cone-beam computed tomography (CBCT). Angulations and length of the styloid process were evaluated in CBCT images of 97 individuals retrospectively. The patients were classified as class I, II, and III groups according to sagittal skeletal classes. The mean length, anterior angulation, and medial angulation of the styloid process were analyzed. Statistical significance was evaluated at p < 0.05. The mean styloid process length in group class III was found to be significantly longer than class I (p: 0.035). Anterior angle was significantly higher in class III group than in other groups (p < 0.05). No statistically significant difference was found in medial angle between the groups (p: 0.506). According to present findings, class III malocclusion is associated with the stylohyoid complex morphology due to longer styloid process lengths and higher anterior angle values.

Tampilan elongasi prosesus styloid pada pasien dengan gangguan sendi temporomandibula

Objectives: The purpose of this case report was to report the finding of styloid process morphology in patients with TMD. &#x0D; Case Report: A 22-years-old female patient came to the radiology installation of Rumah Sakit Gigi dan Mulut Unpad Bandung for a Cone Beam Computed Tomography – 3 Dimension (CBCT-3D) examination with a clinical diagnosis of temporomandibular joint disorders (TMD). CBCT-3D examination results showed a change in the shape and position of the right and left condyle head. The length of the styloid process from the sagittal view on the right side was 34,0 mm and the left side 35,0 mm with the elongation type styloid process according to Langlais et al on the right and the left sides were elongated (type I). The styloid process undergoes bilateral elongation with the same type of elongation between the right and the left sides. Angulation of the styloid process from the coronal view on the right side was 68,6° and the left side 55,9°. There was a change in the shape of the right and left styloid processes from the axial view at the temporal base, middle and the tip of styloid process.&#x0D; Conclusion: TMD provides an abnormality in elongation of styloid process, CBCT is an effective diagnostic imaging modalities in evaluation of styloid process length.

Relationship Between Styloid Process Size and the Skeletal Craniofacial Pattern: A Cross-Sectional Study

Objective: The purpose of this correlation study was to evaluate a possible association between the styloid process size and different craniofacial skeletal patterns, in the sagittal and the vertical planes. Methods: 59 consecutive orthodontic adult patients were selected. The styloid process length was measured on pretreatment panoramic radiographs and the cephalometric skeletal variables on lateral cephalometric radiographs. Data were analyzed using independent sample T-Tests, Mann-Whitney U Tests and Spearman´s partial correlations (=5%). Results: Males exhibited longer styloid processes than females (p=0.029), with a mean difference of 7.5mm. Within each individual, right and left styloid process length was similar (r= 0.77; p&lt;0.001). No relationship was found between the size of the styloid process and the sagittal skeletal pattern. A moderate significant correlation was present between the size of the styloid process and some vertical cephalometric skeletal variables: Ar-Go-Me (r=0.32; p=0.02), PFH/AFH (r=-0.29; p=0.03) and MP-SN (r=0.28; p=0.03). Conclusion: Longer styloid processes tend to be associated with high angle skeletal patterns. Orthodontists, general dentists and oral surgeons should be aware that elongation of the styloid process is more frequently verified in hyperdivergent individuals.

Clinical characteristics and neuroimaging findings in eagle syndrome induced internal jugular vein stenosis.

Eagle syndrome is a condition that causes pharyngeal pain, facial pain, swallowing difficulties, and symptoms of arterial impingement due to the elongated styloid process. However, few reports were about eagle syndrome with venous compression up to now. This study aimed to identify the clinical profiles of the internal jugular vein stenosis (IJVS) related eagle syndrome comprehensively. A total of 27 patients, who were diagnosed as IJVS induced by styloid process compression were enrolled. The clinical manifestations and imaging features were analyzed. Styloid process compression was presented in all of the 27 IJVS patients, in which, the top three symptoms included insomnia (81.5%), tinnitus (63.0%) and head noises (63.0%). The most vulnerable segment of internal jugular vein (IJV) was J3 segment (96.3%). The average styloid process length in our study was 3.7 cm. Hearing impairment was more common in bilateral IJVS (68.8% vs. 18.2%, P=0.018). One patient reported significant relief of symptoms at 1 year follow-up after underwent styloidectomy combined with stenting. Neurological symptoms of eagle syndrome induced IJVS were various, including either arterial or venous issues. Better understanding of this disease entity may be helpful for clinical diagnosis and treatment.

Eagle Syndrome: Symptomatic Elongated Styloid Process

A 60-year-old woman presented to the dental clinic with next complaints during last years: presence of a firm lesion in the projection of the right lateral wall of the oropharynx, periodic discomfort in this area upon eating, and a feeling of tingling. Palpation revealed a non-movable small lesion touching like a bone structure. Three-dimensional computed tomography (Panel A) at the level of cervical spine revealed an abnormal length of a right styloid process (arrow). Its length was 35.2 mm (Panel B, arrow) and the left styloid process reached only 15.6 mm (Panel C, arrow). The variety of treatment strategies were proposed for “abnormally elongated styloid process” (synonym: Eagle syndrome) cases from first cases published by Dr. Eagle and during last 80 years. But our patient rejected the proposed treatment options (including surgery offered at the hospital) due to lack of serious complaints and after realizing that her case is not a tumor-case. In cases when abnormally elongated styloid process combines with a styloid ligament ossification some authors terms condition as a “stylohyoid syndrome.” The variety of symptoms upon Eagle/stylohyoid syndromes gave a right to subdivide them into classical and carotid subtypes.

Cone-Beam Computed Tomographic Evaluation of Styloid Process in Patients With Temporomandibular Disorders and Asymptomatic Individuals.

Elongated styloid processes (ESP) may show clinical symptoms that are readily confused with symptoms associated with temporomandibular disorders (TMDs). The purpose of study was to compare the prevalance and characteristics of ESP in patients with TMD and asymptomatic individuals are examined by cone beam computed tomography. Angulations and length of the styloid process (SP) were evaluated in CBCT images of 100 patients with TMD symptoms and 100 control patients, retrospectively. Differences between the patient and control groups were assessed by analysis independent sample t test. Pearson correlation test was used to evaluate between length and angulation of SP relationship. The mean length of SP in the TMD group was 38.19 ± 8.6 mm for the right and 38.99 ± 8.1 mm for the right side. The mean length of SP in the control group was 36.80 ± 6.3 for the right side and 36.18 ± 6.5 mm for the left side. The mean anterior angulation of the SP in the TMD group was 22.08 ± 5.5 degree in the TMD group and 23.97 ± 4.1 degree in the control group. The mean medial angulation of the SP in the TMD group was 30.57 ± 4.9 degree and 29.89 ± 4.4 degree in the control group. There was no significant difference in length and angle between the groups (P > 0.05). No correlation was found in terms of length and angulations of SP between TMD and control groups.

Elongation of the styloid processes in kidney-transplanted patients: The role of ectopic calcification as possible cause of Eagle syndrome

ABSTRACT Objective: To investigate the relationship between the presence of ectopic calcification in the elongation of the styloid process (SP) and its possible clinical manifestation (Eagle syndrome) in a population of kidney-transplant patients previously treated with hemodialysis. Methods: Digital orthopantomography of 92 kidney-transplanted patients and 68 control subjects were analyzed to measure the length of SPs. Calcium, phosphate, alkaline phosphatase, and parathyroid hormone (PTH) blood levels were also available for comparison. Results: The mean length of SPs was significantly different between groups, as were phosphate and PTH values. Discussion: Renal transplant patients who have been treated with hemodialysis present elongated SPs, presumably due to alterations in phosphate balance and PTH levels. Thus, in cases of orofacial pain in patients with a history of altered bone metabolism, particularly when due to renal insufficiency, Eagle syndrome should be suspected as the main cause of symptoms.

Investigation of the styloid process length in a Greek population.

The styloid process (SP) is a slender cylindrical bony projection of the temporal bone with 2 ligaments and 3 muscles attached to it. Symptomatic SP elongation is also referred to, as Eagle's syndrome. The aim of the present study is to investigate the distribution of the SP length in a young adult Greek population. Moreover, we provide a comparison of the results by using two different methods for assessing SP elongation, as described in the lite- rature. Finally, we explore the possibility of using orthopantomograms (OPGs), as a diagnostic aid by investigating inter-examiner, intra-examiner and inter-exami- nation variability and we propose a limit for SP elongation measurable in OPGs. The sample comprised 805 digital OPGs, taken from student pilots and engineers entering the Hellenic Air Force Academy, from 2008 onwards. Two measuring approaches were selected, one using the temporal bone, as a cranial landmark and the other, using the external auditory meatus. The end tip of the process was always the caudal landmark. The mean SP length was 28.42 ± ± 8.48 mm in males and 26.04 ± 7.69 mm in females, when measured from the temporal bone. The mean SP length was 38.35 ± 8.90 mm in males and 34.24 ± ± 8.63 mm in females, when measured from the external auditory meatus. The length of 30 mm is most commonly used as a starting point for SP elongation. In the total sample, 30.6% of the measured SPs exceeded the length of 30 mm. In males, 33.12% of the SPs were elongated; while in females the corresponding incidence was 20%. One hundred and nineteen (14.8%) SPs were not traceable. The SP is typically detectable and measurable in OPGs. An elonga- ted SP should be kept in mind, since symptoms of elongation may overlap with clinical manifestations of temporomandibular joint disorders.

Assessment of surgical treatment of Eagle's syndrome.

The aim of the study was to assess the effectiveness of surgical treatment of patients with Eagle's syndrome, taking into account both early and late results. The study group consisted of 15 patients who underwent resection of the styloid process due to Eagle syndrome in the period of 2005-2017. During the follow-up visit, the patients were asked to fill in a post-operative questionnaire that compared the pre-operative symptoms and their severity with the patients' current health condition. The VAS pain scale was used to assess each symptom, and the Laitinen scale was used to assess the quality of life. Data from patients' medical records were also included. The results of the surveys were subjected to statistical analysis. The study showed that in 11 out of 15 cases there was a significant improvement in the level of pain (70.5% on average) and an improvement in quality of life (on average 65%) comparing to the pre-operative condition. The Wilcoxon test for binding pairs, the Mann-Whitney test, the Kruskal-Wallis test and the Spearman correlation coefficient were used in the statistical analysis. There were statistically significant correlations between the recorded improvement rate and the length of the resected styloid process and its setting. The study proved that resection of prolonged styloid process from extraoral approach in most cases is an effective method of treatment of Eagle syndrome, that carries low risk of complications.

Clinical and Radiological Evaluation of Elongated Styloid Process in Patients with Temporomandibular Joint Disorder

Objectives: Clinical findings of elongated styloid process (SP) can easily be confused with clinical symptoms associated with temporomandibular joint disorders (TMD). This study aims to investigate the presence of elongated SP in patients with TMD.Materials and Methods: This retrospective study was performed on the digital panoramic radiographs of 300 patients between 14-68 years of age, where the study group consisted of 150 (300 SP) patients diagnosed with TMD and the control group consisted of 150 (300 SP) individuals without TMD. 224 of the patients were female and 76 were male. SP measurement was performed by a physician with radiography experience. The measurement values higher than 30 mm were accepted as elongated SP.Results: There was a significant difference between the TMD group and the control group in terms of SP length (p&amp;lt;0.05). While 62% of the patients with TMD had elongated SP, this rate was 38% in the control group.Conclusions: Elongated SP rate was higher in patients with TMD. Since TMD and Eagle syndrome have similar clinical findings, physicians should consider the differential diagnosis of patients with TMD compared to Eagle's syndrome.

Measurement of Length of Styloid Process by Orthopantomography

Background: Styloid process (SP) is an anatomical structure whose elongation is not well understood. Proper clinical and radiological assessment is needed to detect an elongated SP. Anatomical variation is also common. SP is said to be elongated if longer than 30 mm. Orthopantomogram (OPG) is also an imaging modality by which we can view SP.&#x0D; Objective: The objective of this study was to assess the SP on OPG and identify eagle syndrome.&#x0D; Materials and Methods: The study was conducted on archived OPG radiographs available in the Department of Oral Radiology, Gandaki Medical College Teaching hospital and Research Centre. These radiographs were from patients who were subjected to radiographic examination for other dental problems. The length of SP was measured on both sides using the measurement tool bars on the accompanying analysis software.&#x0D; Results: Average length of SP on males was 26.5 mm ±14.4 mm in right and 25.5 mm ±6.19 mm in left; and on females was 23.78 mm ±5.93 mm on right and 24.7 mm ±10.44 mm in left. Elongated SP was more on males compared to females. Elongated styloid process (ESP) was more prevalent in 21 - 30 years of age group, similarly unilateral and bilateral elongation was also predominant on males compared to females.&#x0D; Conclusion: OPG is also useful for detection of an ESP in patients with or without symptoms and helps to avoid misdiagnosis of tonsillar pain or pain of dental, pharyngeal or muscular origin as well as Eagle syndrome (ES).

Evaluation of Styloid Process and Its Anatomical Variations: A Digital Panoramic Study with Systematic Review.

Aims and Objectives:To evaluate the styloid process (SP) and its anatomical variations on digital panoramic radiographs from the database and also to synthesize the current evidence of literature on SP and anatomical variations along with the systematic review of the relevant studies after making the necessary exclusions.Materials and Methods:A total of 500 panoramic radiographs from the database were examined and evaluated for the length of SP using OmniVue software and for the calcification patterns which were categorized into three types as described by Langlais. The obtained values were analyzed using t-test and Chi-square tests with a significance level of 0.005 and SPSS version 20.0 software.Results and Conclusion:The mean length of the SP in females was found to be 3.7 cm on the right side and 3.8 cm on the left side. The mean length of the SP in males was found to be 3.4 cm on the right side and 3.3 cm on the left side with significant difference between the genders with the P values of 0.0002 and 0.0001, respectively. The length of the SP was significantly longer in females than in males. Type I was the most common SP and was more prevalent in females. The results of the present study along with the wide range of reported incidence of anatomical variations in the form of elongation from the literature extracted through the systematic review suggests the need to reevaluate the range of the normal length of the SP.

A morphological and morphometric study of distal end of ulna with its clinical implications

Background and Aim: The distal end of the ulna is of utmost anatomical importance for normal hand functioning. It can get damaged in various injuries such as avulsion of the ulnar styloid process or ulnar styloid triquetral impaction syndrome. Hence, the aim of this study is to measure the various dimensions of distal end of ulna and to look for its various morphological features. Materials and Methods: The study was conducted on fifty dry ulnae of unknown sex. Length ofstyloid process, width of fovea, and pole and height ofseat were measured. Various morphological features of the distal end of ulna were also noted down. Results: The mean length of styloid process, width of fovea, and pole were 0.55, 0.47, and 0.56 cm, respectively. The mean height of seat was 0.72 cm. In 59.57% of cases, the styloid process was straight and in 78.7% of cases, the tip of the styloid process was blunt. The most common shape of pole was kidney shape in 48% of cases. Conclusion: The results of this study will be useful for hand surgeons in dealing with distal ulnar injuries and even for reconstruction of the distal radioulnar joint with prosthesis of distal end of ulna.

Anatomical relationship between carotid artery and styloid and hyoid bones in patients showing unintended head rotation on CTA.

Styloid process length and styloid/hyoid bone proximity to the internal carotid artery (ICA) have been implicated in certain carotid pathologies (e.g. carotid artery dissection). Neck movement or trauma may contribute to some of these carotid pathologies. Styloid/hyoid bone to ICA distances have never been systematically analyzed in regard to head rotation and head flexion-extension. We studied axial slices on computed tomography angiograms of 103 nondissection patients showing > 1° head rotation. We measured the distance between ICA and the hyoid bone (HICA) and the closest point and the tip of the styloid bone (SCICA and STICA, respectively), the length of the styloid, and the angle of head rotation and head flexion-extension. STICA distances were significantly smaller on the right as compared to the left side in both the right and the left rotating patient groups (right STICA, 4.4mm for the right rotating group and 6.4mm for the left rotating group, p = 0.0091; left STICA, 5.1mm for the right rotating group and 6.9 for the left rotating group, p = 0.034). No significant differences were observed for SCICA and HICA distances between right and left rotating groups, and head flexion-extension did not altered significantly SCICA, STICA, or HICA distances. Both right- and left-sided head rotation seems to be associated with decreased right-sided and increased the left-sided styloid tip to internal carotid artery distances. This has to be studied and confirmed in single patient analyses using more severe head rotation and flexion-extension angles.

Comparative study of cone-beam CT and spiral CT in measuring the length of styloid process

Objective: To compare the difference of measuring the length of styloid process between spiral CT with high resolution and cone-beam CT(CBCT). Methods: Five specimens (including 5 pairs of styloid processes) were selected randomly from the Anatomy Laboratory of Otolaryngology Department, all the specimens underwent spiral CT with high resolution and cone-beam CT retrospectively.With the original DICOM data, the styloid processes were shown in one plate by multiple plate reconstruction technique, and later the length of styloid processes of each specimen were measured separately by software NNT Viewer (to CBCT) or Osrix (to spiral CT with high resolution). Results: The length of styloid processes measured by CBCT and spiral CT was (26.8±5.5) mm and (27.1±5.4) mm respectively, and there was no statistical difference between the two groups. Conclusion: In respect of measuring the length of styloid process, the CBCT has the same value in clinical practice comparing to spiral CT with high resolution.

Radiological Evaluation of the Styloid Process Length Using 64-row Multidetector Computed Tomography Scan.

Background:As elongated styloid process is one of the causes of recurrent oropharyngeal pain and carotid nerve plexus compression called Eagle's syndrome and this length is not similar in different communities, the aim of the current study is to determine average length of styloid process by paranasal multidetector computed tomography.Materials and Methods:This is a retrospective cross-sectional study about 393 patients who underwent paranasal MDCT scan for trauma in Radiology Department without pathologic finding. Styloid length from temporal bone junction to tip of the process was measured using Workstation software. Demographic data including age, sex, and height were gathered from the patients' records, and patients were questioned about symptoms of Eagle's syndrome before trauma. Data were analyzed using SPSS version 20 with the methods of t-test, Chi-square, and ANOVA. P < 0.05 was considered statistically significant.Results:Two-hundred and sixteen males and 177 females underwent MDCT. The length of right, left, and mean length of both sides were 25.4 ± 7.3, 25.2 ± 7.8, 25.3 ± 7.1, respectively. The mean length of both sides' process was more among male that was statistically significant (P = 0.025 and 0.043, respectively). Right and left side styloid process' higher length was in correlation with patient's height (P = 0.002, r = 0.153, P = 0.029, r = 0.110, respectively) and number of symptoms (P < 0.001, r = 0.300, P < 0.001, r = 0.334, respectively).Conclusion:The mean length of styloid process was 25.3 ± 7.1 that was in accordance with some studies and different from others. Styloid process length is higher in males. The length of styloid process is in association with height and number of symptoms as well.