The coexistence of temporomandibular disorders and styloid process fracture: A clinical report

Evaluation of styloid chain calcification related to temporomandibular joint disc displacement: a retrospective cohort study

OBJECTIVES

The present study aimed to evaluate any relationship between elongated styloid process (ESP) and temporomandibular joint disc displacement (TMJD).

STUDY DESIGN

A retrospective cohort study.

SETTING

Dentomaxillofacial Radiology division of Erciyes University Dental Hospital.

PARTICIPANTS

Ninety-four temporomandibular joints (TMJs) of 47 patients were allocated in this study. Intervention-disease: Two experienced dentomaxillofacial radiologists have interpreted all CBCT and MR images. Patients who referred with TMJ disorders were classified according to temporomandibular joint's disc status as normal disc position (ND), displacement with reduction (DWR) and displacement without reduction (DWoR).

METHODS

Main outcome measures: Interpretation of styloid chain calcification pattern and styloid processes length measured linearly on reconstructed sagittal slices of CBCT. Randomization: Cone beam computed tomography (CBCT) and magnetic resonance (MR) images of 154 patients who were admitted between September 1, 2012 and September 1, 2019. Only 47 of them fulfilled the study requirements. Blinding: Single blind of the outcome measurements and interpretations of MR images.

RESULTS

Total 94 TMJs of 47 patients disc status groups were analyzed and defined as DWoR (n = 25), DWR (n = 32), and ND (n = 37). On multivariate analysis, no statistical significant differences were found between groups in terms of styloid process lengths. Mean SP length and standard deviation of disc status groups (DWoR, DWR, and ND) are 35.5 (± 9.8) mm, 34.6 (± 9.2) mm, and 38.3 (± 8.9) mm, respectively. When patients were grouped individually according to their post-MRI diagnosis, the mean styloid process length in the non-temporomandibular joint disc displacement (non-TMJD) patients (47.9 ± 10.8) was significantly higher than the TMJD patients (36.1 ± 9.3). In this study, there is no intervention to cause any harm or side effects.

CONCLUSION

Our results indicate that styloid-stylohyoid syndrome may be misdiagnosed with temporomandibular joint disorder (TMD).

TRIAL REGISTRATION

Clinical Trials NCT04280107.

A truncated temporal styloid process from the Jordanian Ottoman Period: Developmental variant or fracture?

Styloid process (SP) development and its role in an individual's lived experience plays a negligible role in paleopathological research, although a handful of possible Eagle's syndrome cases have been reported. Here, the development of the stylohyoid chain and the medical research of SP variants are reviewed to inform the differential diagnosis of a probable SP fracture in a young adult male associated with the Ottoman Period (13-19thC) in Jordan. The fracture surface of the right SP is smooth rather than irregular, the coloration is uniform with the surrounding cortical bone staining, and no new bone formation is visible. All features are consistent with a perimortem injury. An unossified stylohyal is a differential diagnosis, while the left elongated SP suggests a predisposition to intrinsic injury. The implications of SP fractures are considered.

An unusual etiology of posttraumatic Collet-Sicard Syndrome: a case report

Posttraumatic Unilateral paralysis of the last four cranial nerves (IX-XI), known as collet-Sicard syndrome, is rare following closed head injury. A 21-year-old man presented with slurred speech, hoarseness voice and difficulty swallowing his saliva following closed head trauma. The cranial nerve examination revealed left sided severe dysfunction of cranial nerves VII, IX, X, XI, and XII. A CT-Scan of the neck was performed demonstrating a fracture of the left styloid process at the base of the skull. The Magnetic Resonance Imaging showed unusually well seen lower cranial nerves due to nerve edema. The patient was managed conservatively with steroids and regular sessions of neuromuscular and orthophonic rehabilitation. The nutrition had to be administered by gastrostomy since he was unable to swallow. Six months after the injury a total neurological recovery was noted. We present the exceptional case of Collet-Sicard Syndrome caused by styloid process fracture.

Nonsyndromic Isolated Temporal Bone Styloid Process Fracture

Introduction:

Fracture of the styloid process (SP) of the temporal bone is a rare traumatic injury in normal individuals who are not suffering from Eagle’s syndrome. Diagnosis and management of this problem requires comprehensive knowledge about its signs and symptoms. This study aimed to present an isolated styloid process fracture in a nonsyndromic patient.

Case Presentation:

A 50-year-old male patient was referred to our department with a complaint of sore throat. However, presentation of the problem resembled the symptoms of temporomandibular joint disorder (TMD). Fracture of the SP of the temporal bone was detected on the radiographs. Conservative treatment was undertaken for the patient. The symptoms diminished after about four months.

Conclusions:

Physicians should be aware of the signs and symptoms of different pain sources to prevent misdiagnosis and maltreatment.

A report of post-traumatic Eagle's Syndrome

This paper reports the case of a 39-year-old woman who presented with symptoms of Eagle's Syndrome and an ossified stylohyoid ligament (SHL). Symptoms had developed immediately after trauma to the neck. No injury to the SHL was radiologically observable, but the causal relationship between the trauma and the occurrence of symptoms was evident. A new symptom of Eagle's Syndrome mimicking osteoathrosis of the temporomandibular joint was observed. The risk of misdiagnosis of temporomandibular disorders and the etiological role of neck trauma in Eagle's Syndrome are discussed.