Presentation
Only 3 weeks after her initial presentation did a repeat CT showed a “foreign body” in her right neck. This presentation would lead to an assumption of a migrated fish bone into the neck. [ijcfm.org]
Sex differences in the clinical presentation of acs Several studies provide data on possible sex differences in ACS presentation. [jamanetwork.com]
We present rare and diagnostic radiographic evidence of this on both plain film radiographs and CT scans. [ajnr.org]
The importance of this syndrome, lies in the fact that it may present with a range of commonly encountered, but occasionally potentially serious, symptoms. [bjgp.org]
A 35-year-old man presented with sharp neck pain and a foreign-body sensation in the throat. Computed tomography showed elongated styloid processes, and a diagnosis of Eagle’s syndrome was made. [nejm.org]
Entire Body System
- Pain
The pain caused by Eagle syndrome is a type of nerve pain, which means it is caused by unusual nerve signals, not damage to the painful area. [medicalnewstoday.com]
Symptoms of Eagle syndrome Manifestations of Eagle syndrome include: A nagging or dull pain in the throat, head, neck and face Pain persisting for long durations over days, weeks or even months Pain in the ear on the same side as the pain in the head, [news-medical.net]
Treatment can last anywhere from three months or as an ongoing course for pain management. [colgate.com]
Treatment and prognosis In many cases, once the cause of pain has been attributed to the styloid process rather than a more sinister entity, no further treatment is required, or perhaps analgesics can be offered for pain alleviation. [radiopaedia.org]
- Asymptomatic
Earache Reduced hearing Tinnitus Trouble swallowing or chewing Feeling as though you have something in your throat Pain when yawning or turning your neck Facial pain Only 4 percent of the population have an elongated styloid process and most patients are asymptomatic [colgate.com]
[…] thought to be caused by an elongated styloid process or calcified stylohyoid ligament, the presence of an elongated styloid process is not pathognomonic for Eagle syndrome because many patients with incidental findings of an elongated styloid process are asymptomatic [ajnr.org]
Radiographic features alone are not enough to distinguish the symptomatic from the asymptomatic elongated styloid processes. [jiaomr.in]
The patient was asymptomatic during the following up of 3 months. [kbb-forum.net]
[…] characterised by painful sensation in the head and neck region. 1 This condition was first elucidated by the American Otorhinolaryngologist Watt Weems Eagle in 1937. 2 Most of the patients with styloid elongation or calcified stylohyoid ligament may be asymptomatic [sajr.org.za]
- Inflammation
This small bone can cause a lot of pain where elongation or calcification occurs, causing pinched vessels or nerves in the area and resulting in inflammation. [colgate.com]
However, this diagnosis was challenged when the intraoperative neck exploration showed the suspected foreign body found deep into the submandibular gland and above the hyoid bone with no inflammation surrounding it. [ijcfm.org]
Cervical examination did not reveal lymphadenopathy, palpable masses, or cutaneous inflammation or edema. From an orthopedic point of view, neck, and right shoulder mobility were normal. [jomos.org]
Although few suggest that dystrophic and degenerative changes in the hyoid complex of the styloid process might be the cause for ES, others suggest that cervico-facial inflammations, tumours, tonsillectomies and trauma could play a major role in causing [sajr.org.za]
- Falling
These magnetic pulses induce in the other coil electric voltage pulses at the rise and fall of the magnetic pulses and these electric voltage pulses are conveyed to the electrodes. [patents.justia.com]
As a result of said fall he sustained a fractured skull, followed shortly thereafter by a severe case of disabling active tuberculosis. [casetext.com]
Radiographically, the mineralized styloid process falls under any of the aforementioned types of elongation or the patterns of mineralization. The outcomes of treatment have no bearing on the type of elongation or pattern of mineralization. [jiaomr.in]
- Surgical Procedure
Comments FBS is described as occurring following a surgical procedure in the paracervical region because of a lesion of the sympathetic nerve fibers innervating the parotid gland [ 6 ]. ES is described following SHL ossification. [jomos.org]
[…] visualization of the surgical field. [jiaomr.in]
Gastrointestinal
- Dysphagia
Case Report A 39-year-old woman presented at the Otolaryngology Clinic complaining of dysphagia and vague throat discomfort that she had experienced continuously for slightly more than a year. [ajnr.org]
Through the five years of follow up, she did not have pain or dysphagia. [kbb-forum.net]
Less frequent symptoms are referred otalgia, headache, carotidynia, dizziness, and dysphagia. A range of cranial nerve palsies may occur. Pain is often unilateral and more than one symptom is usual. [bjgp.org]
[…] nerves due to compression of the carotid artery Cranial nerve impingement Patients can have symptoms related to compression and irritation of cranial nerves in the region ( cranial nerves V, VII, IX and X ) such as 1,3 : facial pain when turning the head dysphagia [radiopaedia.org]
Patients typically present with recurrent throat pain, neck or facial pain, sensation of foreign body in the throat, or even dysphagia. The finding of an elongated styloid process is usually incidental, with patients having no related symptoms. [ijcfm.org]
- Odynophagia
[…] or dull pain in the throat, head, neck and face Pain persisting for long durations over days, weeks or even months Pain in the ear on the same side as the pain in the head, neck, face Sensation of something stuck in the throat Pain on swallowing or odynophagia [news-medical.net]
Clin Clin Res. 2018;12(3):89–91 Eagle syndrome is a rare condition where an abnormally elongated (over 3cm) calcified stylohyoid ligament irritates the adjacent soft tissues, causing a number of symptoms related to neck movements, such as local pain, odynophagia [jpccr.eu]
Figure 4: Histology picture of the suspected foreign body showing bone marrow (blue), bone (green), and cartilage (red) Click here to view Discussion Classical symptoms of eagle syndrome are pain or foreign body sensation in the throat, odynophagia, and [ijcfm.org]
Occasionally, it manifests as odynophagia, dysphonia, increased salivation, and headache. Not rarely, patients believe that they have not properly healed from their tonsillectomy. [emedicine.medscape.com]
Variety of symptoms in eagle syndrome is wide; such as craniofacial pain, dysphagia, odynophagia, foreign body sensation, temporary voice changes, tinnitus, otalgia, syncope and focal cerebral symptoms[ 7 ], it may also cause even stroke due to the compression [kbb-forum.net]
Jaw & Teeth
- Bruxism
From a dental management approach, a Michigan-type stabilizing splint or plate was placed for the management of squeeze bruxism. [go.gale.com]
There was no hypertrophy of the masseter muscles, which were soft on palpation, and signs suggesting bruxism were absent. The otorhinolaryngological examination noted an absence of earache or atrial flow, a lack of sinus pathology. [jomos.org]
Eyes
- Foreign Body Sensation
A 35-year-old man presented with sharp neck pain and a foreign-body sensation in the throat. Computed tomography showed elongated styloid processes, and a diagnosis of Eagle’s syndrome was made. [nejm.org]
The irritation might have alerted her to the foreign body sensation and made her more aware of it. [ijcfm.org]
body sensation pain on extending tongue change in voice sensation of hypersalivation tinnitus or otalgia On palpation of the styloid process tip, symptoms should ideally be exacerbated. [radiopaedia.org]
Other symptoms include dysphagia, foreign body sensation in the throat, tinnitus, hypersalivation, transient voice change, or cervicofacial pain. [ejo.eg.net]
An elongated styloid process or calcified stylohyoid ligament triggers symptoms; most frequently as headache, facial pain, dysphagia and sensation of foreign body during swallowing. [kbb-forum.net]
Musculoskeletal
- Neck Pain
Precipitation or exacerbation of symptoms on turning the head and/or neck flexion has been noted in neck pain, transient ischaemic attacks 3 and syncope, with surgical resection of the elongated styloid process proving curative in case reports. 4 Sudden [bjgp.org]
A 35-year-old man presented with sharp neck pain and a foreign-body sensation in the throat. Computed tomography showed elongated styloid processes, and a diagnosis of Eagle’s syndrome was made. [nejm.org]
Patients typically present with recurrent throat pain, neck or facial pain, sensation of foreign body in the throat, or even dysphagia. The finding of an elongated styloid process is usually incidental, with patients having no related symptoms. [ijcfm.org]
[…] movements, such as local pain, odynophagia, dyphagia, otalgia and limited neck mobility. [jpccr.eu]
The pain is typically a dull and throbbing ache that may include a feeling that something is stuck in the throat. Some people also experience tinnitus and neck pain. [medicalnewstoday.com]
Ears
- Otalgia
CASE REPORT: Female 40 years old who complained for 7 years about intense right temporo-parietal headache, associated with ocular pains, otalgia, tinnitus and swallowing problems. These symptoms were unilateral. [ncbi.nlm.nih.gov]
[…] compression and irritation of cranial nerves in the region ( cranial nerves V, VII, IX and X ) such as 1,3 : facial pain when turning the head dysphagia foreign body sensation pain on extending tongue change in voice sensation of hypersalivation tinnitus or otalgia [radiopaedia.org]
89–91 Eagle syndrome is a rare condition where an abnormally elongated (over 3cm) calcified stylohyoid ligament irritates the adjacent soft tissues, causing a number of symptoms related to neck movements, such as local pain, odynophagia, dyphagia, otalgia [jpccr.eu]
Less frequent symptoms are referred otalgia, headache, carotidynia, dizziness, and dysphagia. A range of cranial nerve palsies may occur. Pain is often unilateral and more than one symptom is usual. [bjgp.org]
Government Medical College, Srinagar, Jammu and Kashmir, 190016 India Source of Support: None, Conflict of Interest: None DOI: 10.4103/1012-5574.168363 Eagle syndrome is a symptom complex of recurrent throat pain, dysphagia, foreign body sensation, otalgia [ejo.eg.net]
Face, Head & Neck
- Facial Pain
Symptoms include, but are not limited to: Sore throat Earache Reduced hearing Tinnitus Trouble swallowing or chewing Feeling as though you have something in your throat Pain when yawning or turning your neck Facial pain Only 4 percent of the population [colgate.com]
Discussion Eagle syndrome is an aggregate of symptoms that includes recurrent throat pain, foreign body sensation, dysphagia, and/or facial pain as a direct result of an elongated styloid process or calcified stylohyoid ligament (3). [ajnr.org]
[…] due to compression of cranial nerves due to compression of the carotid artery Cranial nerve impingement Patients can have symptoms related to compression and irritation of cranial nerves in the region ( cranial nerves V, VII, IX and X ) such as 1,3 : facial [radiopaedia.org]
Case report A 35-year-old woman presented to a maxillofacial surgeon with the chief complaint of facial pain over the right face and the temple region. This discomfort had been bothering her for the last 2 years. [ejo.eg.net]
Symptomatic patients may experience a wide spectrum of symptoms, including pain in cervico-facial region, pharyngeal discomfort, painful neck movements, change in voice, painful tongue movements, increased secretion of saliva, otalgia and headache. [sajr.org.za]
Neurologic
- Headache
Get immediate emergency care if suddenly experience any of these symptoms: headache weakness loss of balance changes in vision confusion While Eagle syndrome is rare and poorly understood, it’s easily treated with surgery or medication. [healthline.com]
Exertional headache as unusual presentation of the syndrome of an elongated styloid process. Headache. 2009;49(5):776–779. https://doi.org/10.1111/j.1526-4610.2008.01267.x Ramadan SU, Go¨kharman D, Kacar M, Kos_ar U. [sajr.org.za]
The most common inclusions are glossopharyngeal neuralgia, sphenopalatine neuralgia (also known as Sluder's syndrome), histamine cephalgia (cluster headaches), migraine headaches, carotidynia, myofascial pain dysfunction, impacted third molars, and other [jiaomr.in]
CASE REPORT: Female 40 years old who complained for 7 years about intense right temporo-parietal headache, associated with ocular pains, otalgia, tinnitus and swallowing problems. These symptoms were unilateral. [ncbi.nlm.nih.gov]
Occasionally, it manifests as odynophagia, dysphonia, increased salivation, and headache. Not rarely, patients believe that they have not properly healed from their tonsillectomy. [emedicine.medscape.com]
- Neuralgia
Eagle's syndrome can be a secondary cause of glossopharyngeal neuralgia. Glossopharyngeal neuralgia may be a life-threatening condition as a result of associated cardiovascular complications. [jiaomr.in]
Palabras clave: Apófisis estiloides Neuralgia del glosofaríngeo Síndrome de Eagle Summary Eagle syndrome is characterized by unilateral pain in oropharynx, the side of the face, and cervical region in patients after tonsillectomy. [revistaneurocirugia.com]
Because of the wide range of symptomes, the differential diagnosis is broad and includes glossopharyngeal neuralgia, occipital neuralgia, sphenopalatine neuralgia, temporomandibular disorders, dental infection, tonsillitis, mastoiditis, and migraine[ [kbb-forum.net]
These include the following: Temporomandibular disorders Laryngopharyngeal dysesthesia Hyoid bursitis Sluder syndrome Glossopharyngeal neuralgia Esophageal diverticula Migraine-type headaches Sphenopalatine neuralgia Cervical arthritis Temporal arteritis [emedicine.medscape.com]
Workup
Workup Blood work is required to exclude possible systemic diseases. A complete blood count (CBC) is obtained if infection is suspected. [emedicine.medscape.com]
X-Ray
- Cervical Spine X-Ray
While lateral plain cervical spine X-rays demonstrate an elongated styloid process, the gold standard is CT scanning, with 3D reconstruction, which displays the proximity of an elongated, ossified styloid process to adjacent structures. [bjgp.org]
Treatment
Treatment Surgery is a common and effective treatment for Eagle syndrome. Surgery to shorten the styloid process is the primary treatment for Eagle syndrome. This procedure, called a styloidectomy, can be done through the mouth or neck. [medicalnewstoday.com]
Eagle Syndrome and cervical disc herniation – combined symptomatology and treatment. [jpccr.eu]
Treatment can last anywhere from three months or as an ongoing course for pain management. [colgate.com]
Now, the main treatment for FBS is the intraparotid injection of botulinum toxin (BT) based on different treatment procedures. [jomos.org]
Treatment of Eagle syndrome is both surgical and nonsurgical. Nonsurgical treatments include reassurance, nonsteroidal anti-inflammatory medications, and steroid injections (1). Surgical treatment is by one of two methods. Otolaryngologist W. [ajnr.org]
Prognosis
Treatment and prognosis In many cases, once the cause of pain has been attributed to the styloid process rather than a more sinister entity, no further treatment is required, or perhaps analgesics can be offered for pain alleviation. [radiopaedia.org]
Kannel WBCupples LAGagnon DR Incidence, precursors and prognosis of unrecognized myocardial infarction. Adv Cardiol 1990;37202- 214PubMedGoogle Scholar 75. Nadelmann JFrishman WHOoi WL et al. [jamanetwork.com]
However, the prognosis in surgical failures should also be considered. Compression of the internal carotid artery because of styloid elongation can lead to a transient ischaemic attack which is quite intimidating. [sajr.org.za]
Etiology
Stylohyoid chain ossification: A discussion of etiology. Oral Surg Oral Med Oral Pathol 1989;67:515-20. 13. Guo B, Jaovisidha S, Sartoris DJ, Ryu KN, Berthiaume Ml, Clopton P, et al. [jiaomr.in]
Various etiologic theories have been proposed to explain the development of Eagle syndrome. The first one stresses the congenital elongation of the styloid process due to the persistence of the cartilaginous precursor. [ejo.eg.net]
The pathogenesis of Eagle Syndrome (ES) is still misunderstood, and several theories have been proposed for its etiology. [jomos.org]
Etiology This topic is still being debated. [emedicine.medscape.com]
Although etiology and pathophysiology of this syndrome was poorly understood, it was first defined as “stylalgia”and related to abnormal length of the styloid process or calcified stylohyoid membrane[ 2 ]. [kbb-forum.net]
Epidemiology
EPIDEMIOLOGY There is a lack of robust statistical evidence regarding the true prevalence of Eagle syndrome. [bjgp.org]
Elongated styloid process: an epidemiological study on digital panoramic radiographs. J Clin Exp Dent. 2017 Dec. 9 (12):e1446-52. [Medline]. [Full Text]. Sekerci AE, Soylu E, Arikan MP, Aglarci OS. [emedicine.medscape.com]
Sigurdsson EThorgeirsson GSigvaldason HSigfusson N Unrecognized myocardial infarction: epidemiology, clinical characteristics, and prognostic role of angina pectoris, the Reykavik Study. [jamanetwork.com]
Pathophysiology
The pathophysiological explanation of FBS depends on an irritative or traumatic factor in the sympathetic nerve fibers of the parotid gland. [jomos.org]
The pathophysiological mechanism of symptoms is debated as well. [ajnr.org]
The clinical manifestations of Eagle syndrome have been explained by varied pathophysiological explanations. Fracture of the styloid process may lead to granulation tissue proliferation, which causes pressure on surrounding structures. [ejo.eg.net]
[…] that dystrophic and degenerative changes in the hyoid complex of the styloid process might be the cause for ES, others suggest that cervico-facial inflammations, tumours, tonsillectomies and trauma could play a major role in causing ES. 4 The suggested pathophysiological [sajr.org.za]
Results were derived using three dimensional (3-D) cone-beam computed tomography (CT) scans from 542 patients. [19] Pathophysiology Eagle considered tonsillectomy responsible for the formation of scar tissue around the styloid apex, with consequent compression [emedicine.medscape.com]