Eagle’s Syndrome- Enigma behind Atypical Orofacial Pain

Abstract

Eagle’s Syndrome (ES) is characteristically distinguished by cranio-cervico-pharyngeal signs and symptoms associated with elongation of styloid process which compresses vital neurovascular and muscular elements and other anatomical structures. Elongation of styloid process may cause intense facial pain, dysphagia, headache, otalgia, trismus, buzzing sensations and numerous other symptoms. Ossification of stylohyoid or stylomandibular ligament and/or growth of stylohyoid apophysis cause this elongation. It is not a rare condition; however, it is rarely considered as diagnosis by physicians. Definite diagnosis of this syndrome is difficult as it is frequently confounded by radiological examination, differential diagnosis and other manifestations of cervicopharyngeal pain. Non surgical management include reassurance, anti-inflammatory medications and analgesics; and surgical treatment options include a transoral or transcervical approach to resect elongated styloid process. Hereby, the author report a rare case of ES in a 45-year-old female patient who reported with pain on lateral aspect of her neck and throat bilaterally which had been present for nearly 10 years. On clinical examination, bilateral retromandibular region and tonsillar region were tender on palpation with blunt bony elevation palpable bilaterally. Computed Tomography (CT) scan revealed ossification and elongation of styloid processes bilaterally. Surgery was performed for resection of elongated styloid process bilaterally using retromandibular approach. Patient was discharged on 3rd postoperative day and her complaints resolved within seven days. Patient was symptom free and comfortable at one year postoperative follow-up.

Keywords

• elongation
• resection
• retromandibular
• styloid process
• surgery