Eagle syndrome

Key Clinical Message

Although rare, Eagle syndrome should be always considered in the differential diagnosis in patients with chronic orofacial pain refractory to conventional treatments. Treatment is surgery and exeresis of the styloid process via a transoral or cervical approach depending on clinical and radiological features.

An otherwise healthy 52‐year‐old man presented with neck pain when swallowing or sneezing for a month. He had no neck trauma or remarkable medical and family histories. Computed tomography (CT) revealed ossification of the bilateral stylohyoid ligaments, more significant on right side (Figs 1–3; arrows). There was no evidence of other abnormal findings possibly causing the symptoms. The diagnosis of Eagle syndrome (stylohyoid ligament syndrome) was made, which is known to be characterized by styloid process elongation or stylohyoid ligament ossification, causing neck pain plausibly by compressing adjacent anatomical structures 1, 2. Styloid process may be enlarged (>30 mm in length) in 4% of the population and only a small number (1–5%) of people with enlarged styloid process have symptoms 2, 3, 4. Eagle syndrome is one of the benign causes of cervical dysphagia and chronic orofacial pain 1, 2, 3. Rarely, may the elongated styloid process compress the internal carotid artery that can cause neurological symptoms such as vertigo and syncope 4. CT is useful in diagnosing process 1, 2, 3. Treatment options include either surgical removal or conservative care 1, 2, 3, 5. As the symptoms were not severe in this case, conservative care was selected.

Figures 1–3.

CT revealed ossification of the bilateral stylohyoid ligaments (arrows).

Conflict of Interest

None declared.

Authorship

AB: drafted the article. All authors participated in critical review and in the revision of the articles. All authors gave the final approval of the article. All authors have accountability for all aspects of the work.