Eagle syndrome is considered a rare disease caused by an elongated ossified styloid process or calcified Stylohyoid ligament, the cause of which remains unclear. Styloid process of the temporal bone is a 2.5-3cm projection of the bone corresponding to where stylopharyngeal, stylohyoid and muscles originate . The structures as superior constrictor muscle of pharynx; pharyngobasilar fascia, interior jugular vein, internal and external carotid artery and glossopharyngeal, vagus, accessory and hypoglossal nerves are close to the styloid process.
The symptoms are vague but distressing to the patient can even go to stage of mental depression. Eagle syndrome can occur unilaterally or bilaterally and most frequently results in symptoms of dysphagia, headache, pain on rotation of the neck, pain on extension of the tongue, change in voice and a sensation of hypersalivation.
Although approximately 4% of the population is thought to have an elongated styloid process, only a small percentage between 4% and 10% of this group is thought to actually be symptomatic .
The clinical diagnosis is generally difficult and must be confirmed by radiologic imaging e.g. plain X-ray, OPG or CT scan. In this case, 3D CT findings are shown in a 38 year old man who underwent intra oral styloidectomy.
Treatment of Eagle syndrome is both surgical and nonsurgical. Nonsurgical treatments include reassurance, nonsteroidal anti-inflammatory medications, and antideprresants and steroid injections. Surgical treatment is by one of two methods. Eagle in 1937 used a transpharyngeal approach through which the elongated portion of the styloid process was removed. Although this technique does avoid external scarring, it has been heavily criticized because of the increased risk of deep space neck infection and poor visualization of the surgical field .Alternatively, the elongated portion can be removed by an extra oral approach. Although both procedures are effective in removing an elongated styloid process, the extra oral approach requires major neck surgery resulting in a bad scar.
