Eagle's syndrome, elongated styloid process and new evidence for pre-manipulative precautions for potential cervical arterial dysfunction

Westbrook, Andrea M.; Kabbaz, Vincent J.; Showalter, Christopher

doi:10.1016/j.msksp.2020.102219

Cited by 10 publications

(7 citation statements)

References 89 publications

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“…Posteriormente ao processo estiloide está o forame estilomastoide, por onde saem o nervo facial e a artéria estilomastoide, lateral ao forame estilomastoideo está a sutura timpanomastoide, que abriga o ramo auricular do nervo vago. Medial ao processo estiloide está a artéria carótida interna, a veia jugular interna, o acessório espinhal e os nervos hipoglosso e glossofaríngeo e lateralmente à ponta estiloide está a artéria carótida externa e medialmente a ela está o músculo constritor superior e a fáscia faringobasilar (Scharukh, Basem & Gregory, 2017;Pigache et al, 2018;Westbrook, Kabbaz & Showalter, 2020).…”

Section: Resultsunclassified

“…As mulheres são afetadas com mais frequência do que os homens, em uma proporção de 3: 1. (Ceylan et al, 2008;Scharukh, Basem & Gregory, 2017;Bedi et al, 2019;Waters et al, 2018;Badheya et al, 2017;Mahmoud & Ashour, 2020) Acredita-se que seu crescimento, provoca pressão nas estruturas vizinhas, como nervos e artérias e tonsilas, o que pode gerar sintomas neurais, vasculares e autonômicos como dor facial recorrente, cefaleia, disfagia, disfonia, restrição dos movimentos cervicais e sensação de corpo estranho na garganta (Grossmann & Paiano, 1998;Scharukh, Basem & Gregory, 2017;Westbrook, Kabbaz & Showalter, 2020;Mahmoud & Ashour, 2020;Saccomanno et al, 2018) No estudo de Waters et al (2018), o comprimento estiloide mais longo foi correlacionado com escores aumentados para disfagia e odinofagia. De forma menos comum, já forma encontrados relatos de ataques isquêmicos transitórios reversíveis, consistindo em sintomas oftálmicos e episódios de pré-síncope devido a compressão da artéria carótida e diminuição do fluxo sanguíneo na artéria cerebral medial (Scharukh, Basem & Gregory, 2017;Mahmoud & Ashour, 2020).…”

Section: Resultsunclassified

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Síndrome de Eagle com remoção cirúrgica do processo estiloide calcificado: Relato de caso clínico

Sampaio

Lopes

Araújo

et al. 2021

RSD

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A síndrome de Eagle é uma condição clinica associada a um processo estiloide aumentado, com mais de 25mm de comprimento, o que gera uma compressão de estruturas anatômicas importantes provocando sintomas como dor cervical, dor facial, disfagia, otalgia, limitação de abertura bucal e outros. Por se tratar de uma síndrome rara com sintomas semelhantes a outras condições patológicas, é importante a realização do correto diagnóstico e tratamento. Seu tratamento pode ser conservador ou cirúrgico pela abordagem intra ou extra-oral. Este estudo trata-se de um relato de caso clinico, de um paciente 40 anos de idade, do gênero masculino, diagnosticado com síndrome de Eagle após apresentar sintomatologia dolorosa à abertura de boca, disfagia e otalgia e exame tomográfico evidenciar o processo estiloide com 30mm de comprimento. O tratamento de escolha foi a excisão cirúrgica do processo estiloide através da abordagem extra-oral, garantindo maior controle dos grandes vasos, melhor exposição e menor risco de contaminação bacteriana dos espaços cervicais profundos. Como resultado, o tratamento de escolha foi bem sucedido, com regressão total da sintomatologia, sem complicações.

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Section: Resultsunclassified

Síndrome de Eagle com remoção cirúrgica do processo estiloide calcificado: Relato de caso clínico

Sampaio

Lopes

Araújo

et al. 2021

RSD

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show abstract

“…1,7,8 The incidence of Eagle syndrome varies between 4 and 28 %. [5][6][7]9 In 93% of cases, the elongated styloid process is bilateral but rarely symptomatic. 2,4,6 Clinical presentation is subdivided into two major syndromic entities: The classic syndrome can occur unilaterally or bilaterally, and the symptoms may include neck pain, ear pain, dysphagia and dysphonia, tinnitus, odynophagia, sensation of a foreign body in the throat, and dizziness.…”

Section: Discussionmentioning

confidence: 99%

“…6 Head and neck CT scan is the gold standard by visualizing the entire stylohyoid chain and measuring the length of the styloid process Eagle syndrome is confirmed by a styloid process superior to 3 cm. 2,6,9,10 This elongated styloid process can exceptionally cause mechanical conflict with the internal carotid artery, thus defining the stylocarotid syndrome. 6,7,10 This conflict can lead either to direct arterial compression (corresponding to a hemodynamic mechanism), or to carotid dissection or thrombosis.…”

Section: Discussionmentioning

confidence: 99%

Eagle syndrome as a rare cause of recurrent transient ischemic stroke in Senegal (West Africa)

Loum

Lame

Ndiaye

et al. 2021

Int J Otorhinolaryngol Head Neck Surg

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<p>Eagle syndrome is a rare condition, often characterized by nonspecific symptoms. It is due to an abnormally long or compressive styloid process on surrounding structures. Exceptionally, it can cause neuro-vascular manifestations. We report an observation of Eagle syndrome discovered incidentally in presence of recurrent transient ischemic stroke. A 74-year-old man with no cardiovascular risk factors, was admitted to our department following 4 episodes of transient ischemic stroke with right hemiplegia and aphasia, always rapidly resolving. Head and neck CT scan showed 2 long styloid processes with a marked impingement of the left one against the ipsilateral internal carotid artery. Intraoral styloidectomy was performed. The patient recovered fully and remained free of symptoms without neurological impairment, at 6 months. Eagle syndrome is a rare condition which may lead, exceptionally, to repetitive transient ischemic stroke. Surgical styloidectomy must be considered to reduce the risk of new vascular events and prevent serious complications such as dissection of the internal carotid artery.</p>

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“…9 The stylohyoid chain consists of the vagina processus styloidei in the temporal bone, the styloid process, the stylohyoid ligament, and the hyoid bone. 10 All of these structures derive from Reichert cartilage, the cartilaginous part of the second branchial arch. However, an ongoing controversial discussion about the exact nomenclature of the single part of the chain proceeds in the literature.…”

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confidence: 99%

Differences in the Osseous Ultrastructure in 2 Differing Etiologies of Eagle Syndrome. A Micro-CT Study

Heim¹,

Warwas²,

Singer

et al. 2023

Journal of Craniofacial Surgery

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Objectives: Eagle syndrome is a rare disease caused by an elongated styloid process (type I) or ossified stylohyoid ligament (type II) and causes a heterogeneous symptom complex, ranging from pain in the throat and neck to neurological symptoms and neurovascular entrapment. The 2 different types present differing shapes and ultrastructures and cause different symptoms. This study aimed to distinguish the 2 types by investigating the structures by micro-computed tomography. Methods: Micro-computed tomography was performed and evaluated in n = 10 resected styloid processes from patients diagnosed with Eagle syndrome. The tissues were measured for their shape, ratio of soft tissue and bone amounts, bone volume, and ultrastructure, and compared within the groups. Results: The shapes of the different types were different and the ultrastructure differed between the 2 groups, with an absence of trabecular architecture in type II. The area of bone to nonbone tissues in type I samples was significantly higher compared with type II (P = 0.007). Alike these results, the bone volume and bone-to-soft tissue ratio were significantly higher in type I compared with type II (P = 0.009). Conclusions: The findings suggest that both the popular theories (hyperplasia and metaplasia) may be probable but each solely valid for 1 type of Eagle. Type I may derive from bone hyperplasia with cancellous bone formation and rather high bone density in the elongated styloid process. Type II most likely originates from ligament metaplasia into bone without a compact structure.

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Eagle's syndrome, elongated styloid process and new evidence for pre-manipulative precautions for potential cervical arterial dysfunction

Cited by 10 publications

References 89 publications

Síndrome de Eagle com remoção cirúrgica do processo estiloide calcificado: Relato de caso clínico

Síndrome de Eagle com remoção cirúrgica do processo estiloide calcificado: Relato de caso clínico

Eagle syndrome as a rare cause of recurrent transient ischemic stroke in Senegal (West Africa)

Differences in the Osseous Ultrastructure in 2 Differing Etiologies of Eagle Syndrome. A Micro-CT Study

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