Eagle syndrome (Stylohyoid)-Surgical Treatment

 

Stylohyoid Syndrome- so acalled “Eagle syndrome” is a relatively rare disorder whereby a calcified stylohyoid ligament or elongated styloid process gives rise to a multitude of otolaryngological symptoms.

Eagle syndrome derives it name from W.W. Eagle an Amercian Otolaryngologist who was born in 1898. He first published his data in 1937 with a series of 200 patients presenting with symptoms related to a calcified stylohyoid ligament or elongated styloid process. These symptoms include a pharyngeal foreign body sensation, dysphagia, pain on head rotation, otalgia, dizziness and headaches. The symptoms are attributed to impingement of the glossopharyngeal nerve as it runs close to the styloid process and calcified ligament.

An elongated or calcified stylohyoid ligament does not necessarily indicate Eagle syndrome. The diagnosis is made on the basis of history and exacerbation of pain on palpation of the tonsillar fossa. Another test of diagnostic, and also therapeutic benefit, is that of injecting local anaesthetic into the tonsillar fossa, which should result in diminished symptoms.

Treatment of this condition is often with reassurance and local anaesthetic and steroid injection as mentioned above are required. Many centres believe that treatment for this syndrome is primarily surgical. This can be performed either through an intraoral or external approach. Manual fracture of the styloid process was also proposed

Intraoral approach

The surgeon locates the styloid process by digital palpation of the tonsillar fossa, after removing the Tonsils. After the incision and the identification of the styloid process, it is necessary to split the muscles, to elevate the mucoperiosteum, and, finally, to fracture and excise the styloid process.

 

The advantages of the intraoral approach are that the method is safe, simple, less time consuming, and an external scar is avoided. Intraoral resection of the styloid process is a safe technique.