Fig. 1.

(a-b) A 54-year-old man had a 2-year history of dysphagia to both solids and liquids, which made it difficult to swallow. The patient reported neck pain on both sides of the face and a foreign body sensation during neck rotation on both sides and while opening his mouth. CT examination showed a bilateral elongation of the styloid processes, which was less elongated on the left side than on the right. Sagittal planes on the right (A) and left sides (B) and postprocessing MIP reconstruction with bone algorithm are shown. The styloid processes measured 51 and 37 mm on the right and left sides, respectively. The patient underwent resection of the ossified ligament through an extraoral approach and experienced symptom remission.