Bilateral Atypical Facial Pain Caused by Eagle’s Syndrome

Abstract

Recurrent throat pain, “foreign body” sensation, difficulty in swallowing, or vague facial pain is many times caused by the presence of an elongated styloid process. Many times, this condition is misdiagnosed and the patient is treated for facial neuralgia. But once Eagle’s syndrome is confirmed by clinical and radiological examination, the treatment is always surgical resection. The approach maybe intraoral or extraoral. In this paper, we present a case of Eagle’s syndrome caused by bilateral elongation of the styloid process and where surgical resection of the same gave instant permanent relief for the patient.

Eagle’s Syndrome: An Unusual cause of throat pain-Case Study

“…1 Eagle's syndrome is often misdiagnosed due to its rarity and non-specific symptoms, and delay to diagnosis has been reported to be between 10 and 27 years. 1,3,4 In our case report, it took almost an year for the patient to be diagnosed correctly. Similarly, it has been reported that despite that the patient having knowledge of Eagle's syndrome, it took 4 years to reach the correct diagnosis due to the unusual presentation of his symptoms.…”

“…The styloid process is typically 20 to 30 mm in length, and patients with elongated styloid processes of 40 mm or longer have clinical distress 1,3 . This styloid process elongation could be unilateral or bilateral 4 . It affects around 4% of the general population, with 3:1 female predominance, however only 4% of these people experience associated symptoms 3 .…”

“…These symptoms emerge as a result of an abnormal styloid process irritating and/or compressing neighbouring neurovascular and muscle systems 5 . Eagle's syndrome is often diagnosed through a physical examination that includes palpation of the extended styloid process and radiography, including routine orthopantamograph or CT scan, which is now considered the "gold standard" 4 .…”

Eagle’s syndrome in tertiary health institution, southern region of Nigeria

“…[5] In addition, many studies have shown that symptoms occur when the styloid process is about 40 mm. [6] Watt W Eagle stated that about 4% of individuals whose length of the styloid process is >25 mm in adults could be symptomatic. [7] Godden et al reported that affected individuals with ES seldom develop symptoms.…”

Bilateral Eagle Syndrome

“…The incidence of symptomatic ES in the general population is 0.16%, and only rare bilateral examples have been observed. 2,3 It is of additional interest that ES has recently been associated with hepatolineal (liver and spleen) fusion. 4,5 Because of the compact space in which the styloid presides, ES can present with a variety of manifestation.…”