Prevalence and features of elongated styloid process on imaging studies: a systematic review and meta-analysis

Abstract

Objective To determine the prevalence of the elongated styloid process (ESP) and its characteristics, such as sex and age of the patient, unilateral and bilateral incidence, besides variations between different populations and panoramic and CBCT examinations. Materials and methods A search was performed in six databases (PubMed, Web of Science, Scopus, Cochrane, Lilacs, and Embase) to identify observational studies that used imaging exams and assessed ESP prevalence among panoramic radiograph CBCT examinations, whose transversal prevalence studies were included. Furthermore, studies with a specific group of patients or symptomatic patients were excluded. Additionally, Joanna Briggs Institute checklist was used to evaluate the quality of the studies. A meta-analysis was conducted, then subgroup analyses were performed by grouping studies according to the secondary outcomes, with a significance level set at 5%. The Grading of Recommendations Assessment, Development, and Evaluation system was used to rate the certainty in the evidence. ResultsThe initial search resulted in 1635 studies, from which 39 articles met the inclusion criteria, encompassing 50,655 participants. The sample size varied between 82 and 5,000 participants. The prevalence of the ESP ranged from 1.3 to 94.8%, with an overall prevalence of 30.2%. The bilateral occurrence was higher than the unilateral one, but no significant predilection was observed according to sex, age, or population. The type of imaging examination also showed no difference in its detection. ConclusionThe overall prevalence of ESP was 30.2%, with a propensity for bilaterality, but not for any sex, age, or population geographic location. The imaging examination modality did not influence the diagnosis of ESP. However, the quality level of the studies evaluated was very low, demonstrating the need for more homogeneous primary studies on the prevalence of the ESP with a more standardized methodology. Clinical relevance There is no consensus in the literature regarding the prevalence of the ESP and the characteristics of the affected patients that can cause chronic and debilitating discomfort in the head and neck region. Therefore, knowledge about the prevalence and characteristics of this condition would help dental clinicians reach the correct diagnosis.

Will cone-beam computed tomography add new to the stylohyoid complex analysis?

“…Among the CBCT studies, elongation prevalence ranged from 15.1% to 56.6%. (1,8,13,15,26) This concurred with Nogueira-Reis et al (31) in their systematic review who stated that the prevalence of the elongated SP ranged from 1.3 to 94.8%, with an overall prevalence of 30.2% which is close to the present study. This wide range is mostly due to variability in determining the normal range of SHC length among studies as well as the inherent population variations.…”

“…This was in accordance with previous studies where bilateral involvement surpassed the unilateral. (1,8,31) However, Scaf et al (29) had contradictory result with unilateral elongation of the right side being more common.…”

Recurrent Syncope Related to Carotid Compression in Eagle Syndrome: A Case Report

“…Although “normal SP length” is not constant in the literature, more than 30 mm is usually considered to be excessive [ 2 , 6 , 8 ]. Although a recent systematic review showed an estimated prevalence of 30.2% [ 9 ], the majority of these cases are asymptomatic with only 4% (approximately) presenting symptoms [ 2 ]. In the majority of cases, the elongation of the SP is bilateral.…”

Prevalence and Pattern of Stylohyoid Chain Complex on Panoramic Radiographs: A Retrospective Study

“…Diagnosis of this condition is not easy for the clinician because of its vague symptomatology and symptoms of the impacted third molar, temporomandibular disorders and dental diseases reflected in the relevant area. Therefore, dentists must have sufficient knowledge of the characteristics of SP to diagnose the cause of SP-related symptoms (19).…”