Download PDF
CC BY 4.0 · Int Arch Otorhinolaryngol
DOI: 10.1055/s-0043-1776717
Original Research

Role of the Surgical Approach in the Treatment of Eagle Syndrome

Sahil Kapoor
1   Department of Otorhinolaryngology, Faculty of Medical & Health Sciences, SGT University, Gurugram, Haryana, India
,
Ayushi Gupta 
2   Department of Otorhinolaryngology, ESIC Hospital & PGIMSR Basaidarapur, New Delhi, India
,
Sneha Satya
3   Department of Anesthesia, Faculty of Medical & Health Sciences, SGT University, Gurugram, Haryana, India
,
Poonam K Saidha
4   Department of Otorhinolaryngology, Rama Medical College, Kanpur, India
,
Urvi Saini 
5   Department of Otorhinolaryngology, ESIC Medical College & Hospital, Faridabad, Haryana, India
,
Ankesh Singh
6   Department of Psychiatry, All India Institute of Medical Sciences (AIIMS), New Delhi, India
› Author Affiliations Funding The author(s) declare that they have received no financial support to conduct the present research.
› Further Information
   Permissions and Reprints

Abstract

Introduction Eagle syndrome is a rare and an often misdiagnosed entity in otorhinolaryngology.

Objective To determine the efficacy of the surgical treatment for Eagle syndrome.

Methods The present prospective study included 25 patients who presented with complaints of pain in the throat, ear, and neck, as well as difficulty and/or pain while swallowing; they were assessed for Eagle syndrome. As per patient profile, we performed a clinical assessments along with orthopantomograms (OPGs), three-dimensional computed tomography (3D CT) scans, and cone beam computed tomography (CBCT). Pain was assessed pre- and postoperatively through the Numerical Rating Scale-11 (NRS-11), whose score ranges from 0 to 10. Microscopic tonsillo-styloidectomy was performed in cases in which the conservative treatment failed to relieve pain.

Results The mean age of the entire study population was of 36.08 ± 7.19 years, and the male-to-female ratio was of 1.08:1. Referred otalgia was the commonest (44%) complaint. Radiologically, out of 25 patients, 20 patients presented elongated styloid processes. The longest symptomatic styloid process measured radiographically was of 64.7 mm while the shortest was of 28.2 mm. Out of 20 patients, 12 underwent surgery. The postoperative pain assessment through the NRS-11 was performed on day 0 (3.83 ± 0.83), day 7 (1.5 ± 0.52), week 4 (0.5 ± 0.52), and week 12 (0.41 ± 0.51). By 12 weeks, 7 patients were symptom-free, while 5 patients still reported mild pain.

Conclusion Eagle syndrome associated with an elongated styloid process is not a rarity, but it often goes undiagnosed. Microscopic tonsillo-styloidectomy shows excellent results in the management of patients with Eagle syndrome.

Keywords

Eagle syndrome - elongated styloid process - otalgia - styloidectomy

Ethics Clearance

The present study was approved by the institutional Ethics in Research Committee.




Publication History

Received: 01 March 2022

Accepted: 08 June 2023

Article published online:
15 March 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 

  • References

  • 1 Eagle WW. Elongated styloid processes: Report of two cases. Arch Otolaryngol 1937; 25: 584-587
    CrossrefGoogle Scholar
  • 2 Swain SK, Jena A, Sahu MC, Banerjee A. Eagle's Syndrome: Our experiences in a tertiary care teaching hospital of Eastern India. J Head Neck Physicians Surg 2017; 5: 66-70
    CrossrefGoogle Scholar
  • 3 Radak D, Tanaskovic S, Kecmanovic V, Babic S, Popov P, Gajin P. Bilateral Eagle syndrome with associated internal carotid artery kinking and significant stenosis. Ann Vasc Surg 2016; 34: 271.e15-271.e18
    CrossrefPubMedGoogle Scholar
  • 4 González-García N, Porta-Etessam J, García-Azorín D. Eagle syndrome: toward a clinical delimitation. Neurologia (Engl Ed) 2021; 36 (06) 412-417
    PubMedGoogle Scholar
  • 5 Bokhari M, Graham C, Mohseni M. Eagle Syndrome. 2023. Mar 6. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; ; 2023 Jan-. PMID: 28613540
    Google Scholar
  • 6 Kashyap RR, Kashyap RS, Naik V. KIni R. The styloid process: Morphological variationsin South Indian population. Indian J Otol 2015; 21: 25-28
    CrossrefGoogle Scholar
  • 7 Abuhaimed AK, Alvarez R, Menezes RG. Anatomy, Head and Neck, Styloid Process. [Updated 2020 Jul 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; ; 2020 Jan-27.
    Google Scholar
  • 8 Prakash BSR, Puttannavar R, Bose S, Chakraborty A. Computerized Tomography and Radiological Diagnosis of Two Cases of Eagle Syndrome. International Journal of Medical Science and Current Research 2020; 3 (06) 399-403 (IJMSCR)
    Google Scholar
  • 9 Choi JH. Neglected cause of referred otalgia: Eagle's syndrome. Indian J Otol 2018; 24: 266-267
    Google Scholar
  • 10 Lisan Q, Rubin F, Werner A, Guiquerro S, Bonfils P, Laccourreye O. Management of stylohyoid syndrome: A systematic review following PRISMA guidelines. Eur Ann Otorhinolaryngol Head Neck Dis 2019; 136 (04) 281-287
    CrossrefPubMedGoogle Scholar
  • 11 Vieira EM, Guedes OA, Morais SD, Musis CR, Albuquerque PA, Borges ÁH. Prevalence of elongated styloid process in a central Brazilian population. J Clin Diagn Res 2015; 9 (09) ZC90-ZC92
    PubMedGoogle Scholar
  • 12 Bhuyan Md AH, Afroza S, Nurullah, Kafi MdAH, Hossain MdS. Tonsillo-styloidectomy for Eagle's syndrome: review of 20 cases. Bangladesh J Otorhinolaryngol 2012; 18 (02) 149-155
    CrossrefGoogle Scholar
  • 13 Hajare P, Puneeth Nayak S, Deepthi B, Shashi Kumar T. Eagle's Syndrome: An Underdiagnosed Condition-Case Series in a Tertiary Care Hospital. Indian J Otolaryngol Head Neck Surg 2019; 71 (Suppl. 01) 949-952
    CrossrefPubMedGoogle Scholar
  • 14 Scavone G, Caltabiano DC, Raciti MV. et al. Eagle's syndrome: a case report and CT pictorial review. Radiol Case Rep 2018; 14 (02) 141-145
    CrossrefPubMedGoogle Scholar
  • 15 Castarlenas E, Jensen MP, von Baeyer CL, Miró J. Psychometric Properties of the Numerical Rating Scale to Assess Self-Reported Pain Intensity in Children and Adolescents: A Systematic Review. Clin J Pain 2017; 33 (04) 376-383
    CrossrefPubMedGoogle Scholar
  • 16 Hjermstad MJ, Fayers PM, Haugen DF. et al; European Palliative Care Research Collaborative (EPCRC). Studies comparing Numerical Rating Scales, Verbal Rating Scales, and Visual Analogue Scales for assessment of pain intensity in adults: a systematic literature review. J Pain Symptom Manage 2011; 41 (06) 1073-1093
    CrossrefPubMedGoogle Scholar
  • 17 Malik JN, Monga S, Sharma AP, Nabi N, Naseeruddin K. Stylalgia Revisited: Clinical Profile and Management. Iran J Otorhinolaryngol 2018; 30 (101) 335-340
    PubMedGoogle Scholar
  • 18 Härmä R. Stylalgia: clinical experience of 52 cases. Acta Otolaryngol 1966; 224: 149 +
    Google Scholar