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Frugone-Zambra R, Berzaghi A, Gómez-Álvarez J, Bianchi A, Bortolini S. Eagle and Ernest syndromes: a scoping review. Minerva Dent Oral Sci 2024; 73:119-130. [PMID: 36197280 DOI: 10.23736/s2724-6329.22.04724-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
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.
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Affiliation(s)
| | - Andrea Berzaghi
- Department of Surgery, Medicine and Dentistry, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Alessandro Bianchi
- Department of Surgery, Medicine and Dentistry, University of Modena and Reggio Emilia, Modena, Italy
| | - Sergio Bortolini
- Department of Surgery, Medicine and Dentistry, University of Modena and Reggio Emilia, Modena, Italy
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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: 0] [Impact Index Per Article: 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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Al-Amad SH, Al Bayatti S, Alshamsi HA. Stylohyoid Ligament Calcification and Its Association With Dental Diseases. Int Dent J 2022; 73:151-156. [PMID: 35902309 PMCID: PMC9875230 DOI: 10.1016/j.identj.2022.06.021] [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: 04/02/2022] [Revised: 06/22/2022] [Accepted: 06/24/2022] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVES This research aimed at investigating the relationship between calcification of the stylohyoid ligaments (SHLs) and odontogenic inflammatory events. METHODS Cone-beam computed tomography scans of 175 patients were retrospectively assessed for presence of SHL calcifications. Frequencies of 4 types of odontogenic inflammatory events were assessed using the same scans, namely dental extractions, root canal treatments, furcation lesions, and periapical lesions. Patients were telephone-interviewed and asked about histories of tonsillectomy and head and neck trauma. Mann-Whitney U and binary logistic regression tests were used to assess associations between SHL calcification and mean ranks of odontogenic inflammatory events. RESULTS Calcification of SHLs was detected in 71 (41%) and 58 (33%) patients on the right and left sides, respectively. Tonsillectomy and trauma were reported in 14% and 10% of the sample, respectively. Amongst all inflammatory events, root canal treatments were significantly associated with SHL calcification (U = 2755; Z = -2.1; P = .035). This association was independent from patient age, tonsillectomy, trauma, and other inflammatory events (odds ratio, 1.2; 95% confidence interval, 1.0-1.4; P = .036). CONCLUSIONS This study presents new evidence that intra-oral inflammatory events, particularly related to root canal treatments, have a stronger association with SHL dystrophic calcification than that associated with traditional predisposing factors (ie, old age, tonsillectomy, and trauma).
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Affiliation(s)
- Suhail H. Al-Amad
- Corresponding author. College of Dental Medicine, University of Sharjah, PO Box 27272, Room M28-132, Sharjah, UAE.
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Al-Amad SH, Al Bayatti S, Alshamsi HA. The effect of styloid process medial angulation on Eagle's syndrome's self-reported symptoms: A preliminary cross-sectional study. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 132:52-56. [PMID: 33867305 DOI: 10.1016/j.oooo.2021.02.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 02/15/2021] [Accepted: 02/19/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The aim of this study was to investigate whether the medial angulation of the styloid process (SP), regardless of its length, has an association with self-reported symptoms of Eagle's syndrome. STUDY DESIGN In this cross-sectional study, we measured the length and medial angulation of the SP, including ossification of the stylohyoid ligaments, in archived cone beam computed tomography scans. Patients with valid contact details were interviewed by telephone and asked about the clinical symptoms related to Eagle's syndrome. RESULTS Eighty-eight patients participated in this study. Their median age was 39.0 years and ranged from 18 to 75 years. Thirty-one (35.2%) of the participants reported cervicalgia with at least one other symptom related to Eagle's syndrome. The mean length and angulation of the right SP were 37.2 mm and 36.3°, respectively, with both readings showing positive correlation with the left SP (r = 0.746 and r = 0.670, respectively; P < .001). Medial angulation of the SP was a predictor of Eagle's syndrome self-reported symptoms (odds ratio, 1.082; 95% confidence interval, 1.003-1.167; P = .042), adjusted for SP length and the patient's age. CONCLUSIONS Self-reported clinical symptoms of Eagle's syndrome appear to be more associated with the medial angulation of the SP than with its length. Further research on larger samples is needed to establish the medial angulation cutoff angle and the specific symptoms that are attributed to that angulation.
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Affiliation(s)
- Suhail H Al-Amad
- Associate Professor and Consultant in Oral Medicine, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates.
| | - Saad Al Bayatti
- Lecturer and Specialist in Oral Radiology, College of Dental Medicine, University of Sharjah, Sharjah
| | - Hissa Arif Alshamsi
- Clinical Tutor and General Dentist, College of Dental Medicine, University of Sharjah, Sharjah
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Aoun G, Srour N, El-Outa A, Nasseh I. Styloid process elongation in a sample of Lebanese population: a consideration for the prevention of Eagle syndrome. Med Pharm Rep 2020; 93:410-415. [PMID: 33225268 PMCID: PMC7664728 DOI: 10.15386/mpr-1666] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/15/2020] [Accepted: 05/30/2020] [Indexed: 12/15/2022] Open
Abstract
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.
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Affiliation(s)
- Georges Aoun
- Department of Oral Medicine and Maxillofacial Radiology, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon
| | - Nour Srour
- Department of Oral Medicine and Maxillofacial Radiology, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon
| | - Abbass El-Outa
- Department of Emergency Medicine, American University of Beirut, Beirut, Lebanon
| | - Ibrahim Nasseh
- Department of Oral Medicine and Maxillofacial Radiology, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon
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Kalabalık F, Şahin O. Evaluation of stylohyoid complex in subjects with different types of malocclusions using cone-beam computed tomography: a retrospective study in a Turkish subpopulation. Surg Radiol Anat 2020; 42:1095-1100. [PMID: 32394117 DOI: 10.1007/s00276-020-02486-8] [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: 04/05/2020] [Accepted: 04/29/2020] [Indexed: 11/25/2022]
Abstract
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.
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Affiliation(s)
- Fahrettin Kalabalık
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Izmir Katip Celebi University, Izmir, Turkey
| | - Onur Şahin
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Izmir Katip Celebi University, Aydinlik Evler Mahallesi, Cemil Meric Caddesi, 6780 Sokak No: 48, 35640, Cigli, Izmir, Turkey.
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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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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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Warrier S A, Kc N, K S, Harini DM. Eagle's Syndrome: A Case Report of a Unilateral Elongated Styloid Process. Cureus 2019; 11:e4430. [PMID: 31245217 PMCID: PMC6559395 DOI: 10.7759/cureus.4430] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
When styloid process elongation or stylohyoid ligament calcification can lead to various symptoms, such as dysphagia, facial pain, globus sensation, and headache, it is termed Eagle’s syndrome. It may be unilateral or bilateral. Though the overall prevalence in adults is 4%, only 0.16% of patients are symptomatic. Since the symptoms mimic several other orofacial pains and neuralgia, the diagnosis must be made through a detailed history, clinical examination, and various imaging modalities. The case of facial pain in a 22-year-old female patient who was diagnosed to have a unilateral elongated styloid process is discussed in this paper.
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Affiliation(s)
- Aravind Warrier S
- Oral Medicine and Radiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
| | - Nanthini Kc
- Oral Medicine and Radiology, Adhiparasakthi Dental College and Hospital, Chennai, IND
| | - Subadra K
- Oral Medicine and Radiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
| | - Dhivya M Harini
- Oral Medicine and Radiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
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Yapici Yavuz G, Keskinruzgar A. Clinical and Radiological Evaluation of Elongated Styloid Process in Patients with Temporomandibular Joint Disorder. CUMHURIYET DENTAL JOURNAL 2019. [DOI: 10.7126/cumudj.498907] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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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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Krohn S, Brockmeyer P, Kubein-Meesenburg D, Kirschneck C, Buergers R. Elongated styloid process in patients with temporomandibular disorders — Is there a link? Ann Anat 2018; 217:118-124. [DOI: 10.1016/j.aanat.2018.01.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 01/22/2018] [Accepted: 01/26/2018] [Indexed: 11/17/2022]
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Omami G. Calcification of the stylohyoid complex in Libyans. Saudi Dent J 2018; 30:151-154. [PMID: 29628738 PMCID: PMC5884224 DOI: 10.1016/j.sdentj.2017.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Revised: 11/27/2017] [Accepted: 12/16/2017] [Indexed: 11/23/2022] Open
Abstract
Objective To investigate the prevalence and pattern of calcification of the stylohyoid complex in Libyan population. Material and methods Archived digital panoramic radiographs of 3343 patients were collected; 181 images were excluded for underage or poor image quality. Thus, the images of 3162 patients (1081 men, 2081 women; women-to-men ratio, 2:1; age range, 16–68 years; mean age, 36.7 years) retrieved and assigned to one of four morphological patterns of the stylohyoid complex: regular, elongated, calcified, and undetected. Data were analyzed with the Χ2 test using SPSS (Chicago, IL, USA); P values lower than 0.05 were considered statistically significant. Results Out of 3162 images studied, the styloid process was demonstrated to be regular in 1935 (61.2%), elongated in 541 (17.2%), calcified in 565 (17.8%), and undetected in 121 (3.8%). Symmetric patterns were demonstrated on 2580 (81.6%) images. An elongated stylohyoid complex was significantly more common in women than in men (P = .0404). Conclusion The anatomical patterns of the stylohyoid complex in Libyans were highly variable. Dental clinicians should recognize the various morphological patterns of the stylohyoid complex on panoramic radiographs. Computed tomography studies are recommended for further morphometric analysis of the stylohyoid complex.
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Affiliation(s)
- Galal Omami
- American Board of Oral and Maxillofacial Radiology, United States.,University of Kentucky College of Dentistry, Department of Oral Health Practice, Division of Oral Medicine, Diagnosis and Radiology, 800 Rose Street, Room MN-320, Lexington, KY 40536-0297, United States
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Bruno G, De Stefani A, Balasso P, Mazzoleni S, Gracco A. Elongated styloid process: An epidemiological study on digital panoramic radiographs. J Clin Exp Dent 2017; 9:e1446-e1452. [PMID: 29410761 PMCID: PMC5794123 DOI: 10.4317/jced.54370] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 10/23/2017] [Indexed: 11/16/2022] Open
Abstract
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.
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Affiliation(s)
- Giovanni Bruno
- Department of Neuroscience, School of Dentistry, University of Padua, Padua, Italy
| | - Alberto De Stefani
- Department of Neuroscience, School of Dentistry, University of Padua, Padua, Italy
| | - Paolo Balasso
- Department of Management and Engineering, University of Padova
| | - Sergio Mazzoleni
- Department of Neuroscience, School of Dentistry, University of Padua, Padua, Italy
| | - Antonio Gracco
- Department of Neuroscience, School of Dentistry, University of Padua, Padua, Italy
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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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Gracco A, De Stefani A, Bruno G, Balasso P, Alessandri-Bonetti G, Stellini E. Elongated styloid process evaluation on digital panoramic radiograph in a North Italian population. J Clin Exp Dent 2017; 9:e400-e404. [PMID: 28298982 PMCID: PMC5347289 DOI: 10.4317/jced.53450] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 12/02/2016] [Indexed: 12/03/2022] Open
Abstract
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.
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Affiliation(s)
- Antonio Gracco
- Prof, Department of Neuroscience, School of Dentistry, University of Padua, Padua, Italy
| | - Alberto De Stefani
- DDS, Department of Neuroscience, School of Dentistry, University of Padua, Padua, Italy
| | - Giovanni Bruno
- DDS, Department of Neuroscience, School of Dentistry, University of Padua, Padua, Italy
| | - Paolo Balasso
- Dr, Department of Management and Engineering, University of Padova
| | | | - Edoardo Stellini
- Prof, Department of Neuroscience, School of Dentistry, University of Padua, Padua, Italy
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Arbildo H, Gamarra L, Rojas S, Infantes E, Vásquez H. Eagle syndrome. A narrative review. JOURNAL OF ORAL RESEARCH 2016. [DOI: 10.17126/joralres.2016.054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Vieira EMM, Guedes OA, Morais SD, Musis CRD, Albuquerque PAAD, Borges ÁH. Prevalence of Elongated Styloid Process in a Central Brazilian Population. J Clin Diagn Res 2015; 9:ZC90-2. [PMID: 26501021 DOI: 10.7860/jcdr/2015/14599.6567] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 08/03/2015] [Indexed: 11/24/2022]
Abstract
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.
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Affiliation(s)
- Evanice Menezes Marçal Vieira
- Associate Professor, Department of Oral Diagnosis, School of Dentistry, University of Cuiabá , Cuiabá, Mato Grosso, Brazil
| | - Orlando Aguirre Guedes
- Associate Professor, Department of Endodontics, School of Dentistry, University of Cuiabá , Cuiabá, Mato Grosso, Brazil
| | - Sylvania De Morais
- Associate Professor, Department of Oral Diagnosis, School of Dentistry, University of Cuiabá , Cuiabá, Mato Grosso, Brazil
| | - Carlo Ralph De Musis
- Associate Professor, Department of Oral Diagnosis, School of Dentistry, University of Cuiabá , Cuiabá, Mato Grosso, Brazil
| | | | - Álvaro Henrique Borges
- Associate Professor, Department of Endodontics, School of Dentistry, University of Cuiabá , Cuiabá, Mato Grosso, Brazil
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