Unilateral complete articulated ossification of the stylohyoid apparatus: case report and review of the literature

Abstract

Anatomical variations of the stylohyoid apparatus are frequent. Two types can occur: an elongation of the stylohyoid ligament, from a long styloid process to a complete ossified structure connecting the skull base to the lesser horn of the hyoid bone, or the existence of supernumerary bones in the stylohyoid fibrous matrix, which sometimes resembles phalanges. These variations are in the majority of cases bilateral and symmetrical. The authors report the case of a 43-year-old male patient who presented with an unusual unilateral complete ossification of the stylohyoid apparatus, associated with vertebral and laryngeal calcifications. Original latest generation CT scan and three-dimensional MRI imagery are provided to illustrate this rare case.

Unilateral complete articulated ossification and aberrant thickening of the stylohyoid chain

“…No cartilage had formed between these two segments except for one specimen in which a continuous cartilaginous structure was evident unilaterally (8). This unique variation and the theory that the styloid process continues to ossify slowly into adulthood may explain the complete ossification of the stylohyoid chain (2,6,(8)(9)(10).…”

Stylohyoid complex syndrome: A report of two cases and review of the literature

“…It resembles the radiographic appearance of a long bone with a thick radiopaque cortex and a central radiolucency. Mineralization (calcification) corresponds to calcium phosphate deposition constituting physiological or pathological structures, which do not have the same radiographic or biomechanical signification as bone (Hardy et al, 2014).…”

Asociación entre Calcificaciones del Complejo Estilohioideo y Síntomas Clínicos en Pacientes Atendidos en el Centro de Salud de la Universidad San Sebastián, Sede Santiago, Chile

“…Se ha observado que la prevalencia de variaciones anatómicas en la población puede ir desde un 5 % a un 84 %, sin predilección por sexo y siendo más común la presentación bilateral (Gonçalves, 2016). Por otra parte, también se postula que en su mayoría las calcificaciones son asintomáticas, bilaterales y elongadas (Hardy et al, 2014).…”