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Evanjelin PJ, Tn U. Elongated Styloid Process Evaluation Using Panoramic Radiography in Patients With Oral Submucous Fibrosis: A Retrospective Study. Cureus 2024; 16:e60781. [PMID: 38903350 PMCID: PMC11188970 DOI: 10.7759/cureus.60781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Accepted: 05/21/2024] [Indexed: 06/22/2024] Open
Abstract
Background Oral submucous fibrosis (OSMF) is a chronic condition primarily affecting the buccal mucosa, characterized by fibrotic changes, scarring, and precancerous lesions. Pathologically, it involves inflammation, collagen deposition, and muscular degeneration. Objective This study aimed to assess the prevalence and distribution of elongated styloid process (ESP) in patients diagnosed with OSMF, contributing to the understanding of anatomical variations in this population. Methods A retrospective study was conducted at the Department of Oral Medicine and Radiology of Saveetha Dental College. We collected records of OSMF patients from 2021 to 2023, which included panoramic radiographs. We evaluated the presence, type, and grading of ESP alongside OSMF grades using standardized classifications. Results Out of 125 OSMF patients, 67 (53.6%) had ESP. Type I ESP was most prevalent (83.58%). Bilateral occurrences were more common (52.2%) than unilateral (41.79%). On both sides, type I ESP predominated significantly. Among unilateral cases, left-side occurrences were slightly more frequent. Type I ESP remained predominant regardless of laterality. Conclusion The study highlights the high prevalence of ESP, predominantly type I, in OSMF patients, with bilateral occurrences more common. These findings provide valuable insights into the anatomical variations associated with OSMF, contributing to clinical understanding and potential future research directions.
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Affiliation(s)
- P Jency Evanjelin
- Oral Medicine and Radiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Umamaheswari Tn
- Oral Medicine and Radiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
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Assiri Ahmed H, Estrugo-Devesa A, Roselló Llabrés X, Egido-Moreno S, López-López J. The prevalence of elongated styloid process in the population of Barcelona: a cross-sectional study & review of literature. BMC Oral Health 2023; 23:674. [PMID: 37723455 PMCID: PMC10507983 DOI: 10.1186/s12903-023-03405-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 09/11/2023] [Indexed: 09/20/2023] Open
Abstract
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.
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Affiliation(s)
- Hassan Assiri Ahmed
- Odontological Hospital University of Barcelona, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, L'Hospitalet de Llobregat, Spain
- Departamento de Odontoestomatología, Pabellón de Gobierno, Campus Universitario de Bellvitge - Universidad de Barcelona, C/ Feixa Llarga s/n, L'Hospitalet de Llobregat, Barcelona, 08907, Spain
| | - Albert Estrugo-Devesa
- Odontological Hospital University of Barcelona, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, L'Hospitalet de Llobregat, Spain.
- Departamento de Odontoestomatología, Pabellón de Gobierno, Campus Universitario de Bellvitge - Universidad de Barcelona, C/ Feixa Llarga s/n, L'Hospitalet de Llobregat, Barcelona, 08907, Spain.
| | - Xavier Roselló Llabrés
- Odontological Hospital University of Barcelona, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, L'Hospitalet de Llobregat, Spain
- Departamento de Odontoestomatología, Pabellón de Gobierno, Campus Universitario de Bellvitge - Universidad de Barcelona, C/ Feixa Llarga s/n, L'Hospitalet de Llobregat, Barcelona, 08907, Spain
| | - Sonia Egido-Moreno
- Odontological Hospital University of Barcelona, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, L'Hospitalet de Llobregat, Spain
- Departamento de Odontoestomatología, Pabellón de Gobierno, Campus Universitario de Bellvitge - Universidad de Barcelona, C/ Feixa Llarga s/n, L'Hospitalet de Llobregat, Barcelona, 08907, Spain
| | - José López-López
- Odontological Hospital University of Barcelona, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, L'Hospitalet de Llobregat, Spain
- Departamento de Odontoestomatología, Pabellón de Gobierno, Campus Universitario de Bellvitge - Universidad de Barcelona, C/ Feixa Llarga s/n, L'Hospitalet de Llobregat, Barcelona, 08907, Spain
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Chu MI, Chen CH, Lee CY, Chen YK. Retrospective study of the styloid process in a Taiwanese population using cone beam computed tomography. J Dent Sci 2022; 17:345-353. [PMID: 35028057 PMCID: PMC8740111 DOI: 10.1016/j.jds.2021.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 10/11/2021] [Indexed: 11/25/2022] Open
Abstract
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.
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Affiliation(s)
- Mio-Ieng Chu
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chia-Hui Chen
- Department of Medical Imaging and Radiological Sciences, I-Shou University, Kaohsiung, Taiwan
| | - Chen-Yi Lee
- School of Dental Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yuk-Kwan Chen
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Division of Oral Pathology & Maxillofacial Radiology, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Oral & Maxillofacial Imaging Center, Kaohsiung Medical University, Kaohsiung, Taiwan
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Occurrence of the Elongated Styloid Process on Digital Panoramic Radiographs in the Riyadh Population. Radiol Res Pract 2021; 2021:6097795. [PMID: 34804609 PMCID: PMC8601818 DOI: 10.1155/2021/6097795] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 10/09/2021] [Accepted: 10/26/2021] [Indexed: 11/19/2022] Open
Abstract
Background Patients with an elongated styloid process might present with dysphagia and pain in the cervicofacial region. These patients could be misdiagnosed as other orofacial pathologies. Aim The present study attempted to assess the prevalence of the elongated styloid process on digital panoramic radiographs in the Riyadh population. Materials and Methods The present prospective randomized study was conducted on the panoramic digital radiographs of 300 randomly selected patients visiting a private dental hospital to identify any elongation of the styloid process. Only the radiographs without any magnification errors were considered. The styloid process length was measured using the Sidexis measuring tool and entered in an Excel spreadsheet with other demographic data. A length beyond 30 mm was considered styloid process elongation. The data were subjected to statistical analysis. Results The symptoms of styloid process elongation were higher among females (78.6%), and this difference was statistically significant (χ2 = 7.182; P=0.007). No statistically significant association was observed between styloid process elongation and symptoms between different age groups. Females exhibited a significant longer mean length of the styloid process than males. The present study exhibited a 27.3% prevalence for the elongation and calcification of the styloid process. Conclusion Given the significant prevalence of the elongated styloid process in our study, we recommend it to be considered as one of the differential diagnosis for pain or discomfort in the orofacial region.
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An evaluation of the prevalence of elongated styloid process in Taiwanese population using digital panoramic radiographs. J Dent Sci 2021; 17:744-749. [PMID: 35756808 PMCID: PMC9201539 DOI: 10.1016/j.jds.2021.09.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/15/2021] [Indexed: 11/23/2022] Open
Abstract
Background/purpose Materials and methods Results Conclusion
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Muñoz-Leija MA, Ordóñez Rivas FO, Barrera-Flores FJ, Treviño-González JL, Pinales-Razo R, Guzmán-López S, Elizondo-Omaña RE, Quiroga-Garza A. A proposed extension to the elongated styloid process definition: A morphological study with high-resolution tomography computer. Morphologie 2020; 104:117-124. [PMID: 32070640 DOI: 10.1016/j.morpho.2020.01.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 01/28/2020] [Accepted: 01/29/2020] [Indexed: 06/10/2023]
Abstract
The objective of the present study was to evaluate the morphology and angulation of the styloid process (SP), analyzing results stratified by gender, side and age on asymptomatic patients. We retrospectively analyzed 99 high-resolution computed tomography study images from asymptomatic patients. The images were assessed intra-observatory by a head and neck expert radiologist. Data for length, morphology, and angulation in a coronal and sagittal plane were recorded and stratified by age and gender. Morphology was classified according to the Langlais modified by Guimares classification. The mean lengths were 31.67±0.97mm and 31.64±0.90mm for the right and left sides respectively. Using the Langlais modified by Guimares classification, the normal type was the most prevalent and without a statistically significant difference when comparing between genders. A total of 27.6% presented a morphologically elongated SP (>25mm of continuous process), 49.5% presented a radiologically elongated SP (>30mm), and a total of 9.59% had a longer length than the proposed≤45mm. The right transverse angle was greater in men than women, and a statistically significant difference was found (P=0.010). We show the morphological variability of the SP. Although our results are reported with the traditional definition, the high prevalence supports the need for a new definition of elongated SP and a normal angulation ranges.
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Affiliation(s)
- M A Muñoz-Leija
- Universidad Autónoma de Nuevo León, Facultad de Medicina, Human Anatomy Department, Monterrey, Nuevo León, Mexico
| | - F O Ordóñez Rivas
- Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario "Dr. José Eleuterio González" Department of Radiology and Imaging, Monterrey, Nuevo León, Mexico
| | - F J Barrera-Flores
- Universidad Autónoma de Nuevo León, Facultad de Medicina, Human Anatomy Department, Monterrey, Nuevo León, Mexico
| | - J L Treviño-González
- Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario "Dr. José Eleuterio González", Department of Othorinolaringology, Monterrey, Nuevo León, Mexico
| | - R Pinales-Razo
- Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario "Dr. José Eleuterio González" Department of Radiology and Imaging, Monterrey, Nuevo León, Mexico
| | - S Guzmán-López
- Universidad Autónoma de Nuevo León, Facultad de Medicina, Human Anatomy Department, Monterrey, Nuevo León, Mexico
| | - R E Elizondo-Omaña
- Universidad Autónoma de Nuevo León, Facultad de Medicina, Human Anatomy Department, Monterrey, Nuevo León, Mexico
| | - A Quiroga-Garza
- Universidad Autónoma de Nuevo León, Facultad de Medicina, Human Anatomy Department, Monterrey, Nuevo León, Mexico.
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Eagle syndrome: toward a clinical delimitation. NEUROLOGÍA (ENGLISH EDITION) 2020; 36:412-417. [PMID: 34238523 DOI: 10.1016/j.nrleng.2018.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 03/01/2018] [Indexed: 01/03/2023] Open
Abstract
INTRODUCTION Orofacial and cervical pain are a frequent reason for neurology consultations and may be due to multiple pathological processes. These include Eagle syndrome (ES), a very rare entity whose origin is attributed to calcification of the stylohyoid ligament or elongation of the temporal styloid process. We present a series of five patients diagnosed with ES. METHODS We describe the demographic and clinical characteristics and response to treatment of 5 patients who attended the headache units of 2 tertiary hospitals for symptoms compatible with Eagle syndrome. RESULTS The patients were 3 men and 2 women aged between 24 and 51, presenting dull, intense pain, predominantly in the inner ear and the ipsilateral tonsillar fossa. All patients had chronic, continuous pain in the temporal region, with exacerbations triggered by swallowing. Four patients had previously consulted several specialists at otorhinolaryngology departments; one had been prescribed antibiotics for suspected Eustachian tube inflammation. In all cases, the palpation of the tonsillar fossa was painful. Computed tomography scans revealed an elongation of the styloid process and/or calcification of the stylohyoid ligament in 3 patients. Four patients improved with neuromodulatory therapy (duloxetine, gabapentin, pregabalin) and only one required surgical excision of the styloid process. CONCLUSIONS Eagle syndrome is a rare and possibly underdiagnosed cause of craniofacial pain. We present 5 new cases that exemplify both the symptoms and the potential treatments of this entity.
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Cone-Beam Computed Tomographic Evaluation of Styloid Process in Patients With Temporomandibular Disorders and Asymptomatic Individuals. J Craniofac Surg 2019; 30:2236-2238. [PMID: 31490445 DOI: 10.1097/scs.0000000000005979] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
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.
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Donmez M, Okumus O, Pekiner FN. Cone beam computed tomographic evaluation of styloid process: A retrospective study of 1000 patients. Eur J Dent 2019; 11:210-215. [PMID: 28729795 PMCID: PMC5502567 DOI: 10.4103/ejd.ejd_56_17] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
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.
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Affiliation(s)
- Merve Donmez
- Department of Oral Diagnosis and Radiology, Faculty of Dentistry, Marmara University, Istanbul, Turkiye
| | - Ozlem Okumus
- Department of Oral Diagnosis and Radiology, Faculty of Dentistry, Istanbul Kemerburgaz University, Istanbul, Turkiye
| | - Filiz Namdar Pekiner
- Department of Oral Diagnosis and Radiology, Faculty of Dentistry, Marmara University, Istanbul, Turkiye
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González-García N, García-Azorín D, Porta-Etessam J. Eagle syndrome: Toward a clinical delimitation. Neurologia 2018. [PMID: 30032933 DOI: 10.1016/j.nrl.2018.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVES Orofacial and cervical pain are a frequent reason for neurology consultations and may be due to multiple pathological processes. These include Eagle syndrome (ES), a very rare entity whose origin is attributed to calcification of the stylohyoid ligament or elongation of the temporal styloid process. We present a series of five patients diagnosed with ES. MATERIAL AND METHODS We describe the demographic and clinical characteristics and response to treatment of 5 patients who attended the headache units of two tertiary hospitals for symptoms compatible with Eagle syndrome. RESULTS The patients were three men and two women aged between 24 and 51, presenting dull, intense pain, predominantly in the inner ear and the ipsilateral tonsillar fossa. All patients had chronic, continuous pain in the temporal region, with exacerbations triggered by swallowing. Four patients had previously consulted several specialists at otorhinolaryngology departments; one had been prescribed antibiotics for suspected Eustachian tube inflammation. In all cases, the palpation of the tonsillar fossa was painful. Computed tomography scans revealed an elongation of the styloid process and/or calcification of the stylohyoid ligament in three patients. Four patients improved with neuromodulatory therapy (duloxetine, gabapentin, pregabalin) and only one required surgical excision of the styloid process. CONCLUSIONS Eagle syndrome is a rare and possibly underdiagnosed cause of craniofacial pain. We present five new cases that exemplify both the symptoms and the potential treatments of this entity.
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Affiliation(s)
| | - D García-Azorín
- Hospital Clínico Universitario de Valladolid, Valladolid, España
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Ledesma-Montes C, Hernández-Guerrero JC, Jiménez-Farfán MD. Length of the ossified stylohyoid complex and Eagle syndrome. Eur Arch Otorhinolaryngol 2018; 275:2095-2100. [PMID: 29948265 DOI: 10.1007/s00405-018-5031-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 06/05/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE To assess radiographically the presence of an ossified stylohyoid complex (OSHC) with signs and symptoms of Eagle syndrome or other oro-facial painful diseases in patients attending our institution and to confirm that the important issue for study is to know the length of the ossificated portion of the stylohyoid complex only. METHODS We separated 1000 consecutive files, and after selection, 922 panoramic radiographs were evaluated. Assessed parameters were gender and age of the patients, size, and location of the analyzed OSHCs. In addition, the length parameters of the studied OSHCs were also determined in 100 extra radiographs. RESULTS Normal length of OSHCs was between 2.83 and 4.16 cm and OSHCs measuring more than 4.17 cm long comprising 23.2% of the sample. Any of the patients with OSHC presented signs or symptoms of the Eagle syndrome or any other orofacial painful disease. CONCLUSIONS This is the first study on OSHCs using the mandatory parameters of normal, short and elongated length in the studied population. Our results suggest that the presence of an OSHC is not an important feature for pain detection in the Eagle syndrome and is not an important risk factor for development of throat pain in this and other painful orofacial diseases. Our results are different from those previously published in other populations and suggest that the widely used lengths of 2 to 4 cm for measuring the OSHCs are not adequate parameter. It is desirable to define first the short, normal and abnormal parameters of OSHCs in each studied population.
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Affiliation(s)
- Constantino Ledesma-Montes
- Clinical Oral Pathology Laboratory, Facultad de Odontología, Universidad Nacional Autónoma de México, Ciudad Universitaria, Col. Copilco-CU, 04510, Mexico City, Mexico.
| | - Juan Carlos Hernández-Guerrero
- Laboratory of Immunology, Facultad de Odontología, Universidad Nacional Autónoma de México, Ciudad Universitaria, Col. Copilco-CU, 04510, Mexico City, Mexico
| | - María Dolores Jiménez-Farfán
- Laboratory of Immunology, Facultad de Odontología, Universidad Nacional Autónoma de México, Ciudad Universitaria, Col. Copilco-CU, 04510, Mexico City, Mexico
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AlZarea BK. Prevalence and pattern of the elongated styloid process among geriatric patients in Saudi Arabia. Clin Interv Aging 2017; 12:611-617. [PMID: 28408810 PMCID: PMC5384721 DOI: 10.2147/cia.s129818] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
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.
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Affiliation(s)
- Bader K AlZarea
- Department of Prosthodontics, College of Dentistry, AlJouf University, Sakaka, Kingdom of Saudi Arabia
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Petrović S, Jovanović I, Ugrenović S, Radovanović Z, Pešić Z, Vučković I, Stojković N, Petrović F. Morphometric analysis of the stylohyoid complex. Surg Radiol Anat 2016; 39:525-534. [PMID: 27734098 DOI: 10.1007/s00276-016-1757-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Accepted: 10/07/2016] [Indexed: 11/25/2022]
Abstract
PURPOSE Stylohyoid complex is anatomical structure predisposed to numerous individual variations. These may result in its extreme elongation, medial deviation and finally Eagle's syndrome occurrence. The aim of this study was to measure the length, angulation, evaluate morphological variations of stylohyoid complex by computed tomography and, subsequently, relate obtained data to the gender and the age of the evaluated cases. MATERIALS AND METHODS The material included CT scans of stylohyoid complexes of 282 individuals. The entire length, maximal thickness, and angulation of the stylohyoid complexes in the coronal, transverse, and sagittal planes were measured. RESULTS According to their morphology, orientation and length, stylohyoid complexes were classified into six morphological types. Elongated, bent, segmented, and segmented with attached stylohyoid ligament for the lesser horns of the hyoid bone stylohyoid complex types were characterized by significantly greater length, while pseudoarticulated type was characterized by significantly lower length in relation to normal stylohyoid complex type. The elongated type was additionally significantly thicker and with significantly lower value of medial angle in transverse plain than the normal stylohyoid complex type. Elongated, bent, and segmented types were significantly more frequent in males than in females. Furthermore, the frequency of the elongated stylohyoid complex type increased, whereas normal and pseudoarticulated types decreased with age. CONCLUSIONS In conclusion, elongated and more medially deviated stylohyoid complexes are more frequent in males than in females. Their more frequent presence in the older age groups indirectly connects this phenomenon with the aging process.
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Affiliation(s)
- Sladjana Petrović
- Department of Radiology, School of Medicine, University of Niš, Blvd. dr Zoran Djindjic 81, 18000, Niš, Serbia.
| | - Ivan Jovanović
- Department of Anatomy, School of Medicine, University of Niš, Niš, Serbia
| | - Sladjana Ugrenović
- Department of Anatomy, School of Medicine, University of Niš, Niš, Serbia
| | - Zoran Radovanović
- Department of Radiology, School of Medicine, University of Niš, Blvd. dr Zoran Djindjic 81, 18000, Niš, Serbia
| | - Zoran Pešić
- Department of Maxillofacial Surgery, School of Medicine, University of Niš, Niš, Serbia
| | - Ivica Vučković
- Department of Maxillofacial Surgery, School of Medicine, University of Niš, Niš, Serbia
| | - Nikola Stojković
- Department of Radiology, School of Medicine, University of Niš, Blvd. dr Zoran Djindjic 81, 18000, Niš, Serbia
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Koshy JM, Narayan M, Narayanan S, Priya BS, Sumathy G. Elongated styloid process: A study. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2015; 7:S131-3. [PMID: 26015690 PMCID: PMC4439650 DOI: 10.4103/0975-7406.155861] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 10/31/2014] [Accepted: 11/09/2014] [Indexed: 11/04/2022] Open
Abstract
The styloid process (SP) on the temporal bone is a highly variable formation. The normal length of the SP ranges from 20 to 30 mm. In spite of its being normally distributed in the population, SPs could be divided into two groups - short SPs with >20 mm and long SPs with <20 mm in length. The SP is often denoted as elongated when it is longer than 30 mm or 33 mm. These dimensions, based on early reports, do not respect the natural variation of the SP. The aim of this study is to investigate the natural variation of the length of the SP.
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Affiliation(s)
- Jinu Merlin Koshy
- Department of Anatomy, Sree Balaji Dental College, Bharat University, Chennai, Tamil Nadu, India
| | - Madhu Narayan
- Department of Oral Pathology, Sree Balaji Dental College, Bharat University, Chennai, Tamil Nadu, India
| | - Sankar Narayanan
- Department of Oral Medicine, Sree Balaji Dental College, Bharat University, Chennai, Tamil Nadu, India
| | - B. Sathya Priya
- Department of Anatomy, Sree Balaji Dental College, Bharat University, Chennai, Tamil Nadu, India
| | - G. Sumathy
- Department of Anatomy, Sree Balaji Dental College, Bharat University, Chennai, Tamil Nadu, India
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15
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Shaik MA, Kaleem SM, Wahab A, Hameed S. Prevalence of elongated styloid process in Saudi population of Aseer region. Eur J Dent 2014; 7:449-454. [PMID: 24932120 PMCID: PMC4053670 DOI: 10.4103/1305-7456.120687] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Objective: The study was performed to investigate the prevalence, morphology and calcification pattern of elongated styloid process in Saudi population of Aseer (Southern) region and its relation to gender and sub-age groups. Materials and Methods: This study was analyzed digital panoramic radiographs of 1,162 adults. Any radiograph with questionable styloid process was excluded from the study. The apparent length of the styloid process was measured by a single experienced dental and maxillofacial Radiologist. The elongated styloid process was classified with the radiographic appearance based on the morphology and calcification pattern. The data were analyzed by using Student's t-test and Chi-square test with P value less than 0.05. Results: A total of 1,085 Digital panoramic radiographs showed elongated styloid process of which 686 (63.2%) were noticed in males and 399 (36.8%) were noticed in female patients. There was a statistical significant difference noticed in the mean difference of elongated styloid process between 20-29, 50-59 and 60 years and above sub-age groups. The elongated styloid process was more prevalent in elderly aged male patients (P < 0.05). Type I morphology with calcified out line (a) was the most frequent pattern of calcification noticed in the present study. Conclusion: The panoramic radiographs are economical, easily accessible and useful diagnostic tool for early detection of elongated styloid process with or without symptoms. However, studies with larger sample size would further help to assess the prevalence of this elongated styloid process in Saudi population of various other regions.
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Affiliation(s)
- Mohammed Asif Shaik
- Department of Maxillofacial Diagnostic Sciences, College of Dentistry, King Khalid University, Abha, Kingdom of Saudi Arabia
| | | | - Sultan Mohammed Kaleem
- Department of Maxillofacial Diagnostic Sciences, College of Dentistry, King Khalid University, Abha, Kingdom of Saudi Arabia
| | - Abdul Wahab
- Department of Preventive Dental Sciences, College of Dentistry, King Khalid University, Abha, Kingdom of Saudi Arabia
| | - Shahul Hameed
- Department of Maxillofacial Diagnostic Sciences, College of Dentistry, King Khalid University, Abha, Kingdom of Saudi Arabia
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16
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Oztunç H, Evlice B, Tatli U, Evlice A. Cone-beam computed tomographic evaluation of styloid process: a retrospective study of 208 patients with orofacial pain. Head Face Med 2014; 10:5. [PMID: 24528515 PMCID: PMC3943457 DOI: 10.1186/1746-160x-10-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 02/13/2014] [Indexed: 11/24/2022] Open
Abstract
Introduction The purpose of this study was to assess the structural characteristics of styloid process (SP) by cone-beam computed tomography (CBCT) examination in a patient population suffering from orofacial pain. The second aim was to assess the prevalence of elongated SP and its relation to gender, site and subjective symptoms in the study population. Methods Clinical and radiographic records of 208 patients were evaluated retrospectively. Radiological examinations including measurements of the structure, length, and medial angulations of SP were performed on CBCT images. Results Out of 208 patients, 96 (46%) had not-elongated SP, 28 (13%) had left side, 16 (8%) had right side, and 68 (33%) had bilateral elongation of SP. The patients with elongated SP had significantly decreased angle values. There were no statistically significant differences in length values of SP between males and females in both groups. Significantly increased prevalence of symptoms except headache was observed in patients with elongated SP. Conclusions This study presents the CBCT as an alternative method to CT or panoramic radiographs for the measurement and the assessment of the styloid process. Patients suffering from orofacial pain, who also had elongated SP, had increased rate of corresponding neurological complaints compared with non-elongated ones.
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Affiliation(s)
| | | | - Ufuk Tatli
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Çukurova University, Adana, Turkey.
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Centurion BS, Imada TSN, Pagin O, Capelozza ALA, Lauris JRP, Rubira-Bullen IRF. How to assess tonsilloliths and styloid chain ossifications on cone beam computed tomography images. Oral Dis 2012; 19:473-8. [DOI: 10.1111/odi.12026] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2012] [Revised: 09/16/2012] [Accepted: 09/18/2012] [Indexed: 11/27/2022]
Affiliation(s)
- BS Centurion
- Department of Stomatology, Bauru School of Dentistry; University of São Paulo; São Paulo Brazil
| | - TSN Imada
- Department of Stomatology, Bauru School of Dentistry; University of São Paulo; São Paulo Brazil
| | - O Pagin
- Department of Stomatology, Bauru School of Dentistry; University of São Paulo; São Paulo Brazil
| | - ALA Capelozza
- Department of Stomatology, Bauru School of Dentistry; University of São Paulo; São Paulo Brazil
| | - JRP Lauris
- Departament of Public Health Sciences and Orthodontics and Pediatric Denstistry, Bauru School of Dentistry; University of São Paulo; São Paulo Brazil
| | - IRF Rubira-Bullen
- Department of Stomatology, Bauru School of Dentistry; University of São Paulo; São Paulo Brazil
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Fusco DJ, Asteraki S, Spetzler RF. Eagle's syndrome: embryology, anatomy, and clinical management. Acta Neurochir (Wien) 2012; 154:1119-26. [PMID: 22638594 DOI: 10.1007/s00701-012-1385-2] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Accepted: 05/04/2012] [Indexed: 11/28/2022]
Abstract
BACKGROUND Eagle's syndrome refers to a rare constellation of neuropathic and vascular occlusive symptoms caused by pathologic elongation or angulation of the styloid process and styloid chain. First described in 1652 by Italian surgeon Piertro Marchetti, the clinical syndrome was definitively outlined by Watt Eagle in the late 1940s and early 1950s. METHODS This article reviews how underlying embryologic and anatomic pathology predicts clinical symptomatology, diagnosis, and ultimately treatment of the syndrome. RESULTS The length and direction of the styloid process and styloid chain are highly variable. This variability leads to a wide range of relationships between the chain and the neurovascular elements of the neck, including cranial nerves 5, 7, 9, and 10 and the internal carotid artery. In the classic type of Eagle's syndrome, compressive cranial neuropathy most commonly leads to the sensation of a foreign body in the throat, odynophagia, and dysphagia. In the carotid type, compression over the internal carotid artery can cause pain in the parietal region of the skull or in the superior periorbital region, among other symptoms. CONCLUSIONS Careful recording of the history of the present illness and review of systems is crucial to the diagnosis of Eagle's syndrome. After the clinical examination, the optimal imaging modality for styloid process pathology is spiral CT of the neck and skull base. Surgical interventions are considered only after noninvasive therapies have failed, the two most common being intraoral and external resection of the styloid process.
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Affiliation(s)
- David J Fusco
- Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ 85013, USA
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Paraskevas GK, Raikos A, Lazos LM, Kitsoulis P. Unilateral elongated styloid process: a case report. CASES JOURNAL 2009; 2:9135. [PMID: 20062652 PMCID: PMC2803932 DOI: 10.1186/1757-1626-2-9135] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2009] [Accepted: 12/03/2009] [Indexed: 11/10/2022]
Abstract
An unusual case of a unilaterally elongated styloid process with a length of 5.8 cm was found on a dry skull of a male cadaver. During his life the subject was complaining for reported ipsilateral otalgia presumably due to nerve compression from the elongated styloid process. The symptomatology appeared by such an anatomical variant as well as relative literature is discussed in this paper.
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Affiliation(s)
- George K Paraskevas
- Department of Anatomy, Medical Faculty of Aristotle University of Thessaloniki, PO Box 300, Thessaloniki, 54124, Greece
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