Does the state of dentition effect the type of stylohyoid chain calcification pattern?

Calcification of the stylohyoid complex in Libyans

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.

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.