Surgical management of Eagle syndrome: A 17-year experience with open and transoral robotic styloidectomy

Fitzpatrick, Thomas H.; Lovin, Benjamin D.; Magister, Marcus J.; Waltonen, Joshua D.; Browne, J. Dale; Sullivan, Christopher A.

doi:10.1016/j.amjoto.2019.102324

Cited by 17 publications

(10 citation statements)

References 16 publications

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“…Another limit can be the restricted mouth opening of the patient. Transoral approach can begin with the tonsillectomy; otherwise, it can be tonsil sparing 16,22 . On the contrary, the transcervical approach allows a wider surgical field to manage and avoid the intraoperative risks, in a non‐contaminated field for the deep cervical structures.…”

Section: Discussionmentioning

confidence: 99%

“…Transoral approach can begin with the tonsillectomy; otherwise, it can be tonsil sparing. 16,22 On the contrary, the transcervical approach allows a wider surgical field to manage and avoid the intraoperative risks, in a non-contaminated field for the deep cervical structures. The cons are the external scar, the possible great auricular nerve paresthesia, the injury risk for the mandibular branch of the facial nerve and the longer operative time.…”

Section: Styloidectomy Performed By Cervicotomy ('Open')mentioning

confidence: 99%

“…Surgical management is reserved for patients where conservative treatments fail and consist in the shortening of the styloid process (partial styloidectomy) by transcervical open approach or by transoral approach 15 . In the last few years, the use of transoral robotic surgery (TORS) was proposed as an alternative to traditional transoral styloidectomy 7,16 …”

Section: Introductionmentioning

confidence: 99%

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Transoral robotic styloidectomy for Eagle syndrome: A systematic review

Campisi,

Caranti,

Meccariello

et al. 2024

Clinical Otolaryngology

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ObjectivesThe aim of the study is to conduct a systematic review of the existing literature on styloidectomy performed through transoral robotic surgery (TORS) in Eagle syndrome (ES).Design and SettingTwo independent reviewers (RC and AC) conducted a systematic review of PubMed and Embase databases, seeking articles on TORS performed for ES treatment. The search was conducted in July 2023. The review was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines.ParticipantsThe review included a total of 17 adult patients, comprising 12 females and 5 males, with an average age of 52.2 years, all diagnosed with ES.Main Outcome MeasuresFor each patient, we assessed the overall length of the styloid process, the affected side, total intervention duration, hospitalization duration, pre and postoperative Visual Analogue Scale (VAS) scores, and the presence of minor and major complications.ResultsWe identified 4 articles describing 17 instances of TORS as a surgical treatment for ES in the literature, totaling 18 styloidectomies. The mean age of the patients was 52.2 years, with 12 females and 5 males. The average operation time, inclusive of the docking phase, was 68.8 minutes. Sixteen patients (94.1% of the total) experienced complete symptom disappearance or near‐complete resolution after surgery. One patient (5.9%) showed improvement categorized as 'non‐meaningful.' Only one case of minor complication was reported among the 17 procedures (5.9%).

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Section: Discussionmentioning

confidence: 99%

Section: Styloidectomy Performed By Cervicotomy ('Open')mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Transoral robotic styloidectomy for Eagle syndrome: A systematic review

Campisi,

Caranti,

Meccariello

et al. 2024

Clinical Otolaryngology

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“…In our case, Eagle syndrome was the main diagnostic hypothesis after physical and CT scan result. The symptomatic management of Eagle syndrome with conservative medical treatment, such as antiinflammatory medications, anticonvulsants, antipsychotics, or other analgesics is usually reserved for patients unable to undergo surgical procedure [8]. Surgical treatment presents remission of symptoms without the need for continuous drug use [9] and it is indicated for all patients due to it being the definitive treatment for this condition.…”

Section: Discussionmentioning

confidence: 99%

A Rare Case of Eagle Syndrome Associated with Tonsil Hypertrophy: Case Report with Literature Review

Hafed¹

2021

OJOR

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“…To this day, no standardized treatment algorithm for the elongated styloid process has been established, although various surgical approaches have been described. Even though the traditional approaches (transcervical or transoral styloidectomy) are still in practice, novel modalities such as transoral robotic surgery have been employed lately in select patients, to avoid the potential shortcomings associated with other approaches [ 13 ]. Finally, yet importantly, it is necessary to emphasize perhaps the most significant factor in the “rise of popularity” of Eagle´s syndrome—a newly described neurological symptomatology possibly associated with the elongated styloid process.…”

Section: Introductionmentioning

confidence: 99%

The Syndrome of Elongated Styloid Process, the Eagle’s Syndrome—From Anatomical, Evolutionary and Embryological Backgrounds to 3D Printing and Personalized Surgery Planning. Report of Five Cases

et al. 2020

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Background and Objectives: The symptoms of Eagle’s syndrome are associated with the elongated styloid process of the temporal bone or calcification of the stylohyoid ligament. The first mention of pain syndrome associated with the elongated styloid process dates back to 1937, when it was described by Watt Weems Eagle. Over the last decade, experts in the field have shown a lively interest in the issue of the relationship between the elongated styloid process and various symptoms. This article presents the correlation between the clinical signs of Eagle’s syndrome and alterations in surrounding anatomical structures. It includes a brief review of the evolutionary, embryological and clinical anatomical background of the elongated styloid process. Materials and Methods: Between 2018 and 2019, five patients were admitted to our workplace with 1–3-year history of bilateral or unilateral throat pain, otalgia and pharyngeal foreign body sensation. As a therapeutic novelty in the surgical approach to this condition, we used individual 3D printed models to measure and identify the exact location of the resection of the styloid process without damaging the surrounding anatomical structures, such as the facial, accessory, hypoglossal, and vagal nerves; the internal jugular vein; and the internal carotid artery. Results: Compared to traditional surgical methods without 3D models, 3D models helped to better identify cutting edges and major landmarks used in surgical treatment of Eagle’s syndrome. Printed models provided assistance with the exact location of the styloid process resection position without damaging the surrounding anatomical structures such as the facial, accessory, hypoglossal, and vagal nerves; the internal jugular vein; and the internal carotid artery. Conclusion: In our clinical report, we used 3D printed models for navigation and planning during surgical procedures involving resections of the elongated styloid process. Additionally, we can formulate a new hypothesis: the elongated styloid process is a form of atavism of the bony hyoid apparatus in our evolutionary ancestors that is evolutionarily encoded or arises from disrupted degeneration of the middle portion of embryonal Reichert´s cartilage of the second pharyngeal arch. Under normal conditions, this portion does not ossify but degenerates and transforms into a connective tissue band, the future stylohyoid ligament.

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Surgical management of Eagle syndrome: A 17-year experience with open and transoral robotic styloidectomy

Cited by 17 publications

References 16 publications

Transoral robotic styloidectomy for Eagle syndrome: A systematic review

Transoral robotic styloidectomy for Eagle syndrome: A systematic review

A Rare Case of Eagle Syndrome Associated with Tonsil Hypertrophy: Case Report with Literature Review

The Syndrome of Elongated Styloid Process, the Eagle’s Syndrome—From Anatomical, Evolutionary and Embryological Backgrounds to 3D Printing and Personalized Surgery Planning. Report of Five Cases

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