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European Archives of Oto-Rhino-Laryngology

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01-08-2018 | Head & Neck

Length of the ossified stylohyoid complex and Eagle syndrome

Authors: Constantino Ledesma-Montes, Juan Carlos Hernández-Guerrero, María Dolores Jiménez-Farfán

Published in: European Archives of Oto-Rhino-Laryngology | Issue 8/2018

Abstract

Purpose

To assess radiographically the presence of an ossified stylohyoid complex (OSHC) with signs and symptoms of Eagle syndrome or other oro-facial painful diseases in patients attending our institution and to confirm that the important issue for study is to know the length of the ossificated portion of the stylohyoid complex only.

Methods

We separated 1000 consecutive files, and after selection, 922 panoramic radiographs were evaluated. Assessed parameters were gender and age of the patients, size, and location of the analyzed OSHCs. In addition, the length parameters of the studied OSHCs were also determined in 100 extra radiographs.

Results

Normal length of OSHCs was between 2.83 and 4.16 cm and OSHCs measuring more than 4.17 cm long comprising 23.2% of the sample. Any of the patients with OSHC presented signs or symptoms of the Eagle syndrome or any other orofacial painful disease.

Conclusions

This is the first study on OSHCs using the mandatory parameters of normal, short and elongated length in the studied population. Our results suggest that the presence of an OSHC is not an important feature for pain detection in the Eagle syndrome and is not an important risk factor for development of throat pain in this and other painful orofacial diseases. Our results are different from those previously published in other populations and suggest that the widely used lengths of 2 to 4 cm for measuring the OSHCs are not adequate parameter. It is desirable to define first the short, normal and abnormal parameters of OSHCs in each studied population.

Rodríguez-Vázquez JF, Mérida-Velasco JR, Verdugo-López S, Sánchez-Montesinos I, Mérida-Velasco JA (2006) Morphogenesis of the second pharyngeal arch cartilage (Reichert’s cartilage) in human embryos. J Anat 208:179–189. https://doi.org/10.1111/j.1469-7580.2006.00524.x CrossRefPubMedPubMedCentral

Andrade MGS, Marchionni AMT, Rebello IC, Martinez M, Flores PSC, de Almeida Reis SR (2008) Three-dimensional identification of vascular compression in Eagle’s syndrome using computed tomography: case report. J Oral Maxillofac Surg 66:169–176. https://doi.org/10.1016/j.joms.2006.10.046 CrossRefPubMed

Hoffmann E, Räder C, Fuhrmann H, Maurer P (2013) Styloid–carotid artery syndrome treated surgically with Piezosurgery: a case report and literature review. J Cranio Maxillo Fac Surg 41:162–166. https://doi.org/10.1016/j.jcms.2012.07.004 CrossRef

De Marchettis D (1652) Anatomia Pattavii 13:205

Dwight T (1907) Stylohyoid ossification. Ann Surg 46:721–735CrossRef

Eagle WW (1937) Elongated styloid processes: report of two cases. Arch Otolaryngol 25:584–587. https://doi.org/10.1001/archotol.1937.00650010656008 CrossRef

Bensoussan Y, Letourneau-Guillon L, Ayad T (2014) Atypical presentation of Eagle’s syndrome with hypoglossal nerve palsy and Horner syndrome. Head Neck 36:136–138. https://doi.org/10.1002/hed.23675 CrossRef

Gokce C, Sisman Y, Ertas ET, Akgunlu F, Ozturk A (2008) Prevalence of styloid process elongation on panoramic radiography in the Turkey population from Cappadocia region. Eur J Dent 2:18–22. https://doi.org/10.4103/1305-7456.120687 CrossRefPubMedPubMedCentral

Eagle WW (1958) Elongated styloid process: symptoms and treatment. AMA Arch Otolaryngol 67:172–176. https://doi.org/10.1001/archotol.1958.00730010178007 CrossRefPubMed

10.

Kaufman SM, Elzay RP, Irish EF (1970) Styloid process variation: radiologic and clinical study. Arch Otolaryngol 91:460–463. https://doi.org/10.1001/archotol.1970.00770040654013 CrossRefPubMed

11.

Steinmann EP (1968) Styloid syndrome in absence of an elongated process. Acta Oto Laryngol 66:347–356. https://doi.org/10.3109/00016486809126301 CrossRef

12.

de Andrade KM, Rodrigues CA, Watanabe PCA, Mazzetto MO (2012) Styloid process elongation and calcification in subjects with TMD: Clinical and radiographic aspects. Braz Dent J 23:443–450. https://doi.org/10.1590/S0103-64402012000400023 CrossRefPubMed

13.

Ekici F, Tekbas G, Hamidi C et al (2013) The distribution of stylohyoid chain anatomic variations by age groups and gender: an analysis using MDCT. Eur Arch Otorhinolaryngol 270:1715–1720. https://doi.org/10.1007/s00405-012-2202-5 CrossRefPubMed

14.

Kursoglu P, Unalan F, Erdem T (2005) Radiological evaluation of the styloid process in young adults resident in Turkey’s Yeditepe University faculty of dentistry. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 100:491–494. https://doi.org/10.1016/j.tripleo.2005.05.061 CrossRefPubMed

15.

Bruno G, De Stefani A, Balasso P, Mazzoleni S, Gracco A (2017) Elongated styloid process: an epidemiological study on digital panoramic radiographs. J Clin Exp Dent 9:1446–1452. https://doi.org/10.4317/jced.54370 CrossRef

16.

Monsour PA, Young WG (1986) Variability of the styloid process and stylohyoid ligament in panoramic radiographs. Oral Surg Oral Med Oral Pathol 61:522–526. https://doi.org/10.1016/0030-4220(86)90399-3 CrossRefPubMed

17.

Leite HF, Niccoll-Filho WD, Liberti EA, Madeira MC, Simões S (1988) Prevalência do processo estilóide alongado em crânios humanos. Rev Odontol UNOSHC São Paulo 17:145–151

18.

Langlais RP, Dale AM, Van Dis M (1986) Elongated and mineralized stylohyoid ligament complex: a proposed classification and report of a case of Eagle’s syndrome. Oral Surg Oral Med Oral Pathol 61:527–532. https://doi.org/10.1016/0030-4220(86)90400-7 CrossRefPubMed

19.

Barclay JK, Donaldson KI (1970) Panoramic radiography of the edentulous jaws—a survey of 100 patients. N Zeal Dent J 66:53–60

20.

O’Carroll MK (1984) Calcification in the stylohyoid ligament. Oral Surg Oral Med Oral Pathol 58:617–621. https://doi.org/10.1016/0030-4220(84)90089-6 CrossRef

21.

Ferrario VF, Sigurtab V, Daddonac A et al (1990) Calcification of the stylohyoid ligament: incidence and morphoquantitative evaluations. Oral Surg Oral Med Oral Pathol 69:524–529. https://doi.org/10.1016/0030-4220(90)90390-E CrossRefPubMed

22.

Ilgüy M, Ilgüy D, Güler N, Bayirli G (2005) Incidence of the type and calcification patterns in patients with elongated styloid process. J Int Med Res 33:96–102. https://doi.org/10.1177/147323000503300110 CrossRefPubMed

23.

Balcioglu HA, Kilic C, Akyol M, Ozan H, Kokten G (2009) Length of the styloid process and anatomical implications for Eagle’s syndrome. Folia Morphol 68:265–270

24.

More CB, Mukesh KA (2010) Evaluation of the styloid process on digital panoramic radiographs. Indian J Radiol Imaging 20:261–265. https://doi.org/10.4103/0971-3026.73537 CrossRefPubMedPubMedCentral

25.

Anbiaee N, Javadzadeh A (2011) Elongated styloid process: is it a pathologic condition? Indian J Dent Res 22:673–677. https://doi.org/10.4103/0970-9290.93455 CrossRefPubMed

26.

Eagle W (1948) Elongated styloid process: further observation and a new syndrome. Arch Oto Laryngol 47:630–640. https://doi.org/10.1001/archotol.1948.00690030654006 CrossRef

27.

Eagle W (1949) Symptomatic elongated styloid process; report of two cases of styloid process carotid artery syndrome with operation. Arch Otolaryngol 49:490–503. https://doi.org/10.1001/archotol.1949.03760110046003 CrossRefPubMed

28.

Correll RW, Jensen JL, Taylor JB, Rhyne RR (1979) Mineralization of the stylohyoid-stylomandibular ligament complex. Oral Surg Oral Med Oral Pathol 48:286–291. https://doi.org/10.1016/0030-4220(79)90025-2 CrossRefPubMed

29.

Camarda AJ, Deschamps C, Forest D (1989) Stylohyoid chain ossification: a discussion of etiology (Part. II). Oral Surg Oral Med Oral Pathol 67:515–520. https://doi.org/10.1016/0030-4220(89)90265-X CrossRefPubMed

30.

Prasad KC, Kamath MP, Reddy KJ, Raju K, Agarwal S (2002) Elongated styloid process (Eagle’s syndrome): a clinical study. J Oral Maxillofac Surg 60:171–175. https://doi.org/10.1053/joms.2002.29814 CrossRefPubMed

31.

Zaki HS, Greco CM, Rudy TE, Kubinski JA (1996) Elongated styloid process in a temporomandibular disorder sample: prevalence and treatment outcome. J Prosthet Dent. https://doi.org/10.1016/S0022-3913(96)90032-3 75:399‑405.CrossRefPubMed

32.

Ramadan SU, Gokharman D, Tuncbilek I et al (2007) Assessment of the stylohyoid chain by 3D-CT. Surg Radiol Anat 29:583–588. https://doi.org/10.1007/s00276-007-0239-8 CrossRefPubMed

33.

Rizzatti-Barbosa CM, Di Hipólito O Jr, Di Hipólito V, Ribeiro MC. Domitti SS, Torre-Leon BL (2004) Prevalencia del elongamiento del proceso estiloide en una población adulta totalmente desdentada. Acta Odontol Venez 42:231–235

34.

Onbas O, Kantarcı M, Karasen RM et al (2005) Angulation, length, and morphology of the styloid process of the temporal bone analyzed by multidetector computed tomography. Acta Radiol 8:881–886. https://doi.org/10.1080/02841850500335085 CrossRef

35.

Ramadan SU, Gökharman D, Kosar P et al (2010) The stylohyoid chain: CT imaging. Eur J Radiol 75:346–351. https://doi.org/10.1016/j.ejrad.2010.04.021 CrossRefPubMed

36.

Omnell KA, Gandhi C, Omnel L (1998) Ossification of the human stylohyoid ligament. A longitudinal study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 85:226–232. https://doi.org/10.1016/S1079-2104(98)90431-0 CrossRefPubMed

37.

MacDonald-Jankowski DS (2001) Calcification of the stylohyoid complex in Londoners and Hong Kong Chinese. Dentomaxillofac Radiol 30:35–39. https://doi.org/10.1038/sj/dmfr/4600574 CrossRefPubMed

38.

Okabe S, Morimoto Y, Ansai T et al (2006) Clinical significance and variation of the advanced calcified stylohyoid complex detected by panoramic radiographs among 80-year-old subjects. Dentomaxillofac Radiol 35:191–199. https://doi.org/10.1259/dmfr/12056500 CrossRefPubMed

39.

Reddy RS, Kira CS, Madhavi NS, Raghavendra MN, Satish A (2013) Prevalence of elongation and calcification patterns of elongated styloid process in South India. J Clin Exp Dent 5:e30-e35. https://doi.org/10.4317/jced.50981 CrossRef

40.

Scaf G, de Freitas DQ, Loffredo L de CM (2003) Diagnostic reproducibility of the elongated styloid process. J Appl Oral Sci 11:120–124. https://doi.org/10.1590/S1678-77572003000200007 CrossRefPubMed

41.

Harma R, Stylagia (1967) Clinical experiences of 52 cases. Acta Oto Laryngol 63(Sup224):149–155. https://doi.org/10.3109/00016486709123570 CrossRef

42.

Ghosh LM, Dubey SP (1999) The syndrome of elongated styloid process. Auris Nasus Larynx 26:169–175. https://doi.org/10.1016/S0385-8146(98)00079-0 CrossRefPubMed

43.

Frommer J (1974) Anatomic variations in the stylohyoid chain and their possible clinical significance. Oral Surg Oral Med Oral Pathol 38:659–667. https://doi.org/10.1016/0030-4220(74)90382-X CrossRefPubMed

Title: Length of the ossified stylohyoid complex and Eagle syndrome
Authors: Constantino Ledesma-Montes
Juan Carlos Hernández-Guerrero
María Dolores Jiménez-Farfán
Publication date: 01-08-2018
Publisher: Springer Berlin Heidelberg
Published in: European Archives of Oto-Rhino-Laryngology / Issue 8/2018
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-018-5031-3

At a glance: The STEP trials

Springer Medicine

Length of the ossified stylohyoid complex and Eagle syndrome

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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