Cone-beam computed tomographic evaluation of styloid process: a retrospective study of 208 patients with orofacial pain

Retrospective evaluation of ponticulus posticus prevalence, sella turcica types, and stylohyoid complex calcifications in a group of Turkish population

The aim of this retrospective analysis was to assess the incidence of ponticulus posticus and stylohyoid ligament calcification and to evaluate the morphological variations of the sella turcica within the Turkish demographic using CBCT scans. Involving a retrospective review of 460 CBCT scans and utilizing the NewTom 3G system, the study analyzed high-quality CBCT images to investigate ponticulus posticus, stylohyoid ligament calcifications, and sella turcica morphology. The ponticulus posticus was examined for complete or partial formations, while the stylohyoid ligament was classified according to its elongation and calcification patterns. The sella turcica was categorized into six distinct morphological types, enhancing the understanding of structural variations in the context of the Turkish population. The calcification patterns of the styloid processes were examined on both sides of 380 individuals, revealing the highest prevalence in the 'd' and 'e' categories on the right, and similar findings on the left among 373 individuals. Symmetric calcification patterns were more common, with 68.4% symmetry observed. For the sella turcica, category 'a' was the most frequent among 363 individuals. Analysis of ponticulus posticus absence and presence showed a majority lacking this feature on both sides, with complete and partial forms less common. The study highlights the anatomical variability and bilateral symmetry of the styloid processes, sella turcica, and ponticulus posticus, illustrating that these structures do not significantly vary with gender or age. These results hold clinical significance for the diagnosis and treatment of related conditions, prompting further investigation into their impact on patient care.

Eagle and Ernest syndromes: a scoping review

INTRODUCTION

Ossification disorders can affect the stylohyoid ligament as well the stylomandibular ligament. The symptomathology between those syndromes and other pathologies it has been a problem because there is not a guideline.

EVIDENCE ACQUISITION

With the aim to establish prevalence, diagnosis and etiopathogenesis of Eagle and Ernest syndromes, a scoping review was performed base on PRISMA criteria.

EVIDENCE SYNTHESIS

To review stylohyoid ligament and Eagle Syndrome 93 articles were selected. Three articles regarding the stylomandibular ligament and Ernest Syndrome were founded and selected.

CONCLUSIONS

Both syndromes should be clinically diagnosed and corroborate with imaging (2D or 3D), although imaging in Ernest Syndrome is not clear as well in Eagle Syndrome. A decisional algorithm for diagnosis of Eagle Syndrome and Ernest Syndrome is presented.

The prevalence of elongated styloid process in the population of Barcelona: a cross-sectional study & review of literature

BACKGROUND

Styloid process (SP) is a cylindrical bony projection that originates from the inferior part of the petrous temporal bone just anteriorly to the stylomastoid foramen. Several nerves, muscles, and ligaments are related closely to the (SP). It is considered elongated when the measurement exceeds 30 mm. The overall prevalence of the styloid process is between 3.3% to 84.4%. The elongation of the styloid process (ESP) is associated with the manifestation of Eagle's Syndrome (ES) which is characterized by various types of pain in the head and neck region such as headache, tinnitus, otalgia, and trigeminal neuralgia. Eagle's syndrome occurs in 4-10.3% of individuals with an elongated styloid process (ESP). The objective of the study is to determine the prevalence of (ESP) in the patients who were treated in the Dental Hospital University of Barcelona (HOUB), to review the literature to spot the light on the different demographic data worldwide.

METHODS

The archived panoramic image in the University of Barcelona dental Hospital were consecutively retrieved to investigate the prevalence of (ESP). Of all digital panoramic radiographs (OPG), 400 met the inclusion criteria and were furtherly analyzed. The results are correlated with the participant's gender, age, and occurrence. Age is subcategorized into three groups. A chi-square test is used to measure the significant differences and the P-value is set at < 0.05 for the level of significance.

RESULTS

Among the included 400, we found 291 demonstrating (ESP). The prevalence of (ESP) which exceeds 30 mm is 72.75%. It is found that the most common morphological type is type 1 which is regarded as the uninterrupted (ESP) regardless of gender and age group. Concerning the calcification pattern, the most prevalent is the partial calcified (ESP) despite genders and age groups.

CONCLUSION

(OPG) is a sufficient tool for the screening of the elongated styloid process. Regarding the prevalence, our results are considered higher than previously reported prevalence in different populations using (OPG) radiography tool. A study on a wider spectrum of the Spanish population is recommended to further investigate the correlation between the elongated styloid process and the occurrence of Eagle's syndrome.

Prevalence and Pattern of Stylohyoid Chain Complex on Panoramic Radiographs: A Retrospective Study

Objective: The elongated styloid process (SP) and calcified stylohyoid ligament can be evaluated radiologically and are associated with some symptoms and syndromes. This study aimed to define the incidence of different stylohyoid chain patterns and classify them. Methods: Digital panoramic radiographs of 1217 patients were included in the study. The styloid chain patterns were analyzed according to MacDonald-Jankowski’s study. Data analysis was performed using the IBM SPSS Statistics 21.0 (Statistical Package for Social Sciences) program. Descriptive values were analyzed by using descriptive statistics. The data were assessed by using Chi-squared tests. A probability level of less than .05 (p ˂ .05) was considered significant. Results: The prevalence of the stylohyoid chain complex patterns was higher for normal SP (86.5%), followed by elongated SP (7.1%), calcified stylohyoid ligament (2.2%), and absent stylohyoid chain (2.8%). Unclassified SP was detected in twenty individuals on the left (1.6%) and fourteen on the right (1.2%). In view of symmetry of the stylohyoid chain complex, 979 (80.4%) were symmetric, 238 (19.6%) were asymmetric and 14 (1.15%) of the asymmetrical ones were unilateral. There was no significant difference in gender for the type of stylohyoid chain complex pattern (p > .05). There was statistically significant difference between the stylohyoid complex pattern and age groups for the right and left sides (p < .05). Conclusion: The authors believe that this study provides additional information about the frequency of the elongated styloid process and provides valuable knowledge of the anatomical variations of the SP. Current findings should be correlated with clinical symptoms in future studies

Comparison of the Length of Styloid Process in Panoramic Radiographs to Computed Tomography as the Gold Standard

Aims

To compare the length of styloid process assessed using computed tomography (CT) and panoramic radiographs (PAN).

Materials and Methods

PAN were taken for 15 patients requiring CT reporting to PMS Dental College or metro scans, after obtaining informed consent and fulfilling all the inclusion and exclusion criteria. CT images were taken in metro scans. The apparent lengths of styloid process were measured in both CT and PAN using software provided with the respective machines. Ethical committee approval was obtained from PMS Dental College, Trivandrum.

Results

The length of left styloid process in CT was observed 20-30 mm in 4 (27%) patients and same in PAN was observed in 5 (33%) patients. Out of 15 patients, abnormal styloid process (length >30 mm) was observed in 11 (73%) patients when measured with CT and 10 (67%) patients in PAN. In CT, the length of the styloid process on the right side was observed between 20 and 30 mm, in 3 (20%) patients. PAN of 2 (13%) patients were found between 20 and 30 mm. On the right side, abnormal styloid process (length >30 mm) was noted in 12 (80%) patients using CT and 13 (87%) patients in PAN. The length of styloid process in the combined sample (both right and left side) was found to be between 20 and 30 mm in 3 (10%) patients and styloid process >30 mm long (in both CT and PAN) was observed in 12 (40%) patients.

Conclusions

This study demonstrated positive correlation between CT and panoramic measurements. "P" values were statistically significant on both sides with values of right side (P = 0.01) and left side (P = 0.002), respectively. Hence, PAN, which are routinely taken, cost-effective and involving relatively low radiation dose, may be used as substitute for CT for the purpose of diagnosis of elongated styloid process. However, for precise measurement of the length of styloid process, CT is still the imaging modality of choice.

Retrospective study of the styloid process in a Taiwanese population using cone beam computed tomography

Background/purpose

Review of literature, evaluation of the styloid process (SP) using cone beam computed tomography (CBCT) has not been performed in a Taiwanese population. Our study aimed to evaluate the different characteristics of SP using CBCT in a Taiwanese population.

Materials and methods

CBCT scans of 121 patients (55 males, 66 females; mean age, 27 ± 9.09 years) were evaluated to assess the length, morphological type, calcification pattern, and angulation of the SP. A SP length greater than or equal to 30.00 mm is considered to indicate an elongated SP (ESP). ESP was classified in terms of morphology as Type I: uninterrupted; Type II: pseudo-articulated; or Type III: segmented. The calcification pattern of SP was categorized as Type A: calcified outline; Type B: partially calcified; Type C: nodular; or Type D: completely calcified. The transverse and sagittal angles between the bilateral SP were also measured.

Results

One-hundred and nine patients had a bilateral SP and 12 patients had a unilateral SP. The mean SP length was 26.34 ± 7.44 mm. Forty-two (34.71%) patients had an ESP. The most common ESP morphology was Type 1, followed by Type II, then Type III, while the calcification pattern prevalence was of the descending order Type B, Type A, Type C, and Type D. The mean transverse and sagittal angles were 66.90 ± 5.41° and 26.67° ± 6.50°, respectively.

Conclusion

The present study was the first to evaluate the characteristics of SP in a Taiwanese population using CBCT. The data contribute a useful basis for clinical investigation of the SP in future.

Styloid process elongation in a sample of Lebanese population: a consideration for the prevention of Eagle syndrome

BACKGROUND

The objective of this study was to investigate the prevalence and patterns of styloid process elongation in a general Lebanese population sample.

METHODS

Digital panoramic radiographs of 489 Lebanese adults (218 males and 271 females, mean age of 47.56 ± 16.149) were included in this retrospective study. First, we screened for detection of elongated styloid process, then we analyzed these cases and classified the elongation types. Data obtained were transformed into SPSS v24 and descriptive and inferential analyses were done.

RESULTS

In our sample, elongated styloid process was seen in 76 cases (15.5%) (45/271 women and 31/218 men). Despite no significant gender predisposition, females were slightly more affected than males (59.2% females to 40.8% males). As for the age, elongation was significantly more likely to be present at 45-64 years of age. The right side was slightly more affected than the left side (86.8% vs. 76.3% respectively), with type 1 elongation as the most common. Nevertheless, bilateral elongation was much more common than unilateral elongation (63.2%).Interestingly, females were more likely to suffer from bilateral elongation (64.58%) compared to men (35.41%).

CONCLUSION

Elongated styloid process represents a common finding detected fortuitously on panoramic radiographs. Therefore, being a main feature in Eagle syndrome, dentists should be aware of this clinical entity and actively screen for it.

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.

Evaluation of stylohyoid complex in subjects with different types of malocclusions using cone-beam computed tomography: a retrospective study in a Turkish subpopulation

PURPOSE

According to the functional matrix theory, the development of maxillomandibular complex may be affected by the surrounding tissues. The aim of this study was to evaluate the length and angulation of the styloid process in different types of malocclusions using cone-beam computed tomography (CBCT).

METHODS

Angulations and length of the styloid process were evaluated in CBCT images of 97 individuals retrospectively. The patients were classified as class I, II, and III groups according to sagittal skeletal classes. The mean length, anterior angulation, and medial angulation of the styloid process were analyzed. Statistical significance was evaluated at p < 0.05.

RESULTS

The mean styloid process length in group class III was found to be significantly longer than class I (p: 0.035). Anterior angle was significantly higher in class III group than in other groups (p < 0.05). No statistically significant difference was found in medial angle between the groups (p: 0.506).

CONCLUSION

According to present findings, class III malocclusion is associated with the stylohyoid complex morphology due to longer styloid process lengths and higher anterior angle values.

Cone-Beam Computed Tomographic Evaluation of Styloid Process in Patients With Temporomandibular Disorders and Asymptomatic Individuals

OBJECTIVES

Elongated styloid processes (ESP) may show clinical symptoms that are readily confused with symptoms associated with temporomandibular disorders (TMDs). The purpose of study was to compare the prevalance and characteristics of ESP in patients with TMD and asymptomatic individuals are examined by cone beam computed tomography.

METHODS

Angulations and length of the styloid process (SP) were evaluated in CBCT images of 100 patients with TMD symptoms and 100 control patients, retrospectively. Differences between the patient and control groups were assessed by analysis independent sample t test. Pearson correlation test was used to evaluate between length and angulation of SP relationship.

RESULTS

The mean length of SP in the TMD group was 38.19 ± 8.6 mm for the right and 38.99 ± 8.1 mm for the right side. The mean length of SP in the control group was 36.80 ± 6.3 for the right side and 36.18 ± 6.5 mm for the left side. The mean anterior angulation of the SP in the TMD group was 22.08 ± 5.5 degree in the TMD group and 23.97 ± 4.1 degree in the control group. The mean medial angulation of the SP in the TMD group was 30.57 ± 4.9 degree and 29.89 ± 4.4 degree in the control group. There was no significant difference in length and angle between the groups (P > 0.05).

CONCLUSION

No correlation was found in terms of length and angulations of SP between TMD and control groups.

Cone beam computed tomographic evaluation of styloid process: A retrospective study of 1000 patients

Objective:

The styloid process (SP) is a bony projection, located just anterior to the stylomastoid foramen, the normal length of which is approximately 20–30 mm. The length of SP when exceeds 30 mm it is said to “elongated.” The purpose of this retrospective study was to assess the prevalence of elongated SP (ESP) by cone beam computed tomography (CBCT) examination in Turkish subpopulation and its relation to gender and age.

Materials and Methods:

This study analyzed CBCT of 1000 patients who were randomly selected to participate and were aged from 14 to 78 years. Any radiograph with questionable SP was excluded from the study. The apparent length and thickness of the SP were measured by two dental and maxillofacial radiologists. The ESP was classified with radiographic appearance-based morphology of elongation. The data were analyzed with the IBM SPSS Statistics 20.0.

Results:

The mean age of patients was 42.49 ± 14.83 years. The length of SP was measured over 30 mm in 151 patients (15.1%). A total of 151 CBCT showed ESP, of which 87 (57.6%) were noticed in males and 64 (42.4%) in female patients. The length of right-sided SP ranged from 30.05 to 85.49 mm and left-sided SP from 30.14 to 83.72 mm.

Conclusion:

CBCT is a valuable diagnostic imaging tool which makes accurate length measurements. It is important for the clinicians to be aware of natural variations of the SP whose clinical importance is not well understood.

The validity of panoramic radiograph as a diagnostic method for elongated styloid process: A systematic review

Objective: To evaluate the validity of panoramic radiograph as a radiographic method for the diagnosis of an elongated styloid process (ESP) in the general population. Methods: An electronic search of available articles about ESP was conducted on PubMed. Sequential screenings based on previously defined exclusion and inclusion criteria were performed. Results: Eight studies were included in the systematic review. Prevalence of ESP and mean radiological length of the styloid process (SP) increased with age, which might be due to a chronic calcification development of the SP. Most of the included studies also asserted that there was no statistically significant correlation between ESP and the gender. Discussion: Panoramic radiograph is easy to perform and interpret, so it can be defined as being useful for diagnosis of ESP in the general population. In symptomatic patients, it can help in the differential diagnosis with other conditions associated with orofacial and neck pain.

Evaluation of the styloid process in a Sri Lankan population using digital panoramic radiographs

OBJECTIVE

The objectives of this study were to evaluate the normal radiographic length of the styloid process (SP), prevalence and type of elongation, and angulation of the styloid process in relation to sex and side on digital panoramic radiographs in a Sri Lankan population.

METHODS

A total of 100 digital panoramic images selected from the database at the Division of Oral Medicine and Radiology, Faculty of Dental Sciences, University of Peradeniya, Sri Lanka were evaluated for the radiological features of the styloid process. Lengths greater than 30 mm were consider as elongated. Elongated styloid processes were also classified into three types based on Langlais classification (elongated, pseudo articulated; and segmented).

RESULTS

The mean radiological length of the SP on the right and left side was 25.8 mm ± 7.5 mm and 23.2 mm ± 9.0 mm respectively. The prevalence of elongated styloid process in males and female were 34.9% and 24.6%. The maximum length observed on right and left sides were 43.2 mm and 41 mm respectively. However, the differences between the genders and the sides were statistically not significant (P = 0.199). The most frequently observed type of elongation was type I (elongated) according to the Langlais classification.

CONCLUSION

This study provides valuable knowledge of the anatomical variations of the SP which may help clinicians from various specialties to diagnose the Eagle syndrome.

Imaging in Orofacial Pain

Imaging usefulness in the diagnosis of orofacial pain includes all modalities that cover the soft tissue and bony structures in the region of the head and neck. Imaging techniques may include 2-dimensional and/or 3-dimensional imaging modalities. Both dentists and physicians should be aware of orofacial pain associated with a variety of sources and select the appropriate imaging technique based on the patient's medical and dental history and the clinical examination. The goal of imaging is to provide the clinician with information that will confirm or deny findings of the clinical examination and allow for the selection of an appropriate treatment.

Elongated styloid process: An epidemiological study on digital panoramic radiographs

Background

The styloid process is a projecton of the temporal bone, its lenght is between 20 to 30 mm, when it is longer than 30 mm it is defined elongated styloid process. The aim of this study is an epidemiological evaluation of 1003 digital panoramic radiographs in an Italian population between 5 and 90 years old.

Material and Methods

This is a retrospective analysis and the radiographs were selected from the Complex Operating Unit of Dentistry of Padua University Hospital database. The radiographs were performed using a Sirona Ortophos XG and the styloid process length was measured using the measuring tool of Sidexis Software. It was measured from the point where it left the temporal bone plate to its tip. Styloid processes measuring more than 30 mm were considered elongated. Chi-squared test, Fligner-Killeen test, Shapiro-Wilk test and t-test with Welch correction were performed.

Results

In the study 33.40% of the patients showed an elongated styloid process.

Conclusions

The number of patients with elongated styloid process and the mean length of the process increase with the age confirming the chronic development of the calcification described in literature. No statistically significant correlation is found between the presence of elongated styloid process and the gender and affected side (bilateral or unilateral).

Key words:Elongated styloid process, panoramic radiograph, epidemiological study, Eagle’s syndrome.

Prevalence and pattern of the elongated styloid process among geriatric patients in Saudi Arabia

OBJECTIVE

The objectives of this study were to assess the elongation of the styloid process on digital panoramic radiographs and to evaluate the prevalence of the elongation according to age, sex and types.

PATIENTS AND METHODS

Digital panoramic radiographs of 198 geriatric edentulous patients were analyzed. The radiographic length of the styloid process was measured on both sides using the measurement toolbars on the accompanying analysis software. For statistical analysis, Student's t-test, chi-square test and analysis of variance test were used.

RESULTS

The elongated styloid process was seen in 87 of the 198 patients. It was observed that as age increased, elongation of the styloid process increased with a male predominance. Type I elongation was more common than other types of elongation. Bilateral elongation was most commonly found than unilateral elongation, and both types of elongation were frequently seen in males compared with females.

CONCLUSION

The prevalence of the elongated styloid process in the present study was higher in comparison to the other reports from edentulous patients.

Elongated styloid process evaluation on digital panoramic radiograph in a North Italian population

Background

The aim of this study is to evaluate the prevalence of elongated styloid process in digital panoramic radiographs in a North Italian population in relation to age, gender and side.

Material and Methods

This study was performed as a retrospective analysis on digital panoramic radiographs of 600 (271 males and 329 females) Italian patients between 6 and 87 years old. The styloid process length were measured using the measuring tool of Sidexis Software. It was measured from the point where it left the temporal bone plate to its tip. Styloid processes measuring more than 30 mm were considered elongated. Chi-squared and Fisher tests were used and the test is considered significant if the p-value is lower or equal to 0.05.

Results

Thirty-three per cent of the patients showed an elongated styloid process. Seventeen per cent were elongated on both right and left side, fifteen point nine per cent were elongated only in one side.

Conclusions

The prevalence of elongated styloid process was high and a progressive increase of the elongation prevalence was found in older groups.

Key words:Elongated styloid process, Eagle’s syndrome, panoramic radiograph.

Relationship of stylohyoid chain and cervical internal carotid artery detected by 3D angiography

OBJECTIVE

The calcification of the stylohyoid chain (SHC), elongated styloid process (SP), larger SP' angle and its shortened distance of cervical internal carotid artery (CICA) are risk factors for bony compression and the stylocarotid syndrome.

METHODS

3D-CTAs of 125 patients were analyzed in terms of the SP length, its angulations, type of the SHC and relationships of its proximity to the CICA.

RESULTS

Elongated SP was observed frequently both in females (47%) and males (55%). The mean distance of the CICA to the SP was calculated as 8.2 ± 3.3 mm. This short distance between the CICA and the SP was observed more frequently in males (28.1%) and females (10.7%). The anterior and medial angulations of the SP were calculated as 71.2 ± 4.3°, and 57.3 ± 9.3°, respectively. In the present study, the SHC was determined as normal SP (54.2%), absence of the SP (1%), duplication of the SP (1%), elongated SP (26%), complete ossification of the SHC (1%), segmentation of the SHC (9%), fracture of ossification of the SHC (1.6%) and pseudo articulations of the SHC (5.6%).

CONCLUSION

3D-CTA was the most appropriate radiological investigation analyzing and measuring SHC (elongated, larger angle, shorter distances with CICA) and identifying types (duplicated, segmented, complete and fractured) resulting from pressures on the CICA. Our study also revealed the pressure on the artery not only arose from the tip of the SP but could also result from types stretching over the artery wall. In those specimens, there is a higher probability of formation of the stylocarotid syndrome due to the long-term pressure on the sympathetic chain around the CICA.

Prevalence of Elongated Styloid Process in a Central Brazilian Population

BACKGROUND

Eagle's syndrome comprises a rare disorder caused by compression of an elongated or deformed styloid process or ossified/calcified stylohyoid ligament on neural and vascular structures. It is characterized by facial and neck pain and can be confused with a wide variety of facial neuralgias, oral and dental diseases and temporomandibular disorders. An imaging evaluation associated with a careful clinical examination, are mandatory in structuring a correct differential diagnosis and in the establishment of a proper therapeutic protocol.

AIM

To investigate the prevalence of the elongated styloid process in a Central Brazilian population and its relation to gender, age and side.

MATERIALS AND METHODS

Digital panoramic radiographs of 736 patients (412 female and 324 male, with a mean age of 35.03 years) were consecutively selected from a private radiology clinic's secondary database. The apparent length of the styloid process was measured from the point where the styloid left the tympanic plate to the tip of the process by two specialists in dental radiology, with the help of the measuring tools on the accompanying software. Styloid process measuring more than 30 mm was considered elongated. The statistical analysis included frequency distribution and cross tabulation. The data were analysed by using Chi-squared tests. The level of significance was set at 5% for all analyses.

RESULTS

A total of 323 (43.89%) radiographic images were suggestive of elongated styloid process. No statistically significant difference was found between the genders, although a higher prevalence was noticed in female participants. Approximately, 31% of the elongated styloid process was observed in 18-53-year-old participants (p < 0.05). Two hundred and sixty seven styloid processes (36.28%) were elongated on both right and left sides.

CONCLUSION

The prevalence of elongated styloid process was high and no statistically significant correlation was found between the presence of elongated styloid process and the studied variables with the exception of the age.