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Berrada K, El Ouali I, Zahi H, Fikri M, Jiddane M, Touarsa F. Bilateral carotid dissection due to Eagle syndrome. Radiol Case Rep 2024; 19:927-933. [PMID: 38188950 PMCID: PMC10767265 DOI: 10.1016/j.radcr.2023.11.028] [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: 10/29/2023] [Revised: 11/07/2023] [Accepted: 11/08/2023] [Indexed: 01/09/2024] Open
Abstract
Eagle syndrome is defined as a collection of symptoms affecting the cervical and cranial regions, resulting from an elongated styloid process or ossified stylohyoid ligament encroaching on surrounding structures and causing a variety of symptoms. Classically, Eagle syndrome presents as neck, throat, or ear pain. Carotid artery dissection is a rare complication of Eagle syndrome. We report the case of a 40-year-old man who presented with bilateral internal carotid artery dissection secondary to pathological elongation of the styloid processes.
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Affiliation(s)
- Kenza Berrada
- Department of Radiology, Ibn Sina University Hospital, Mohammed V University, Rabat, Morocco
| | - Ibtissam El Ouali
- Department of Radiology, Ibn Sina University Hospital, Mohammed V University, Rabat, Morocco
| | - Hiba Zahi
- Department of Radiology, Ibn Sina University Hospital, Mohammed V University, Rabat, Morocco
| | - Meriem Fikri
- Department of Radiology, Ibn Sina University Hospital, Mohammed V University, Rabat, Morocco
| | - Mohamed Jiddane
- Department of Radiology, Ibn Sina University Hospital, Mohammed V University, Rabat, Morocco
| | - Firdaouss Touarsa
- Department of Radiology, Ibn Sina University Hospital, Mohammed V University, Rabat, Morocco
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Acikgoz A, Akkemik O. Prevalence and Radiographic Features of Head and Neck Soft Tissue Calcifications on Digital Panoramic Radiographs: A Retrospective Study. Cureus 2023; 15:e46025. [PMID: 37766776 PMCID: PMC10522404 DOI: 10.7759/cureus.46025] [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] [Accepted: 09/26/2023] [Indexed: 09/29/2023] Open
Abstract
Background In this study, we aimed to determine the prevalence and radiographic features of incidental head and neck soft tissue calcifications (STCs) on panoramic imagesand assess their clinical significance. Methodology Following well-established training and calibration procedures, 9,553 digital panoramic radiographs (DPRs) taken between January 1, 2021, and January 31, 22, were retrospectively evaluated. Only obvious calcifications and clear differential diagnoses were considered. The presence, type, side (i.e., unilateral or bilateral), number (single or multiple), and the presence of different calcifications in the same individual were recorded. STCs were recorded according to age and gender. Data were analyzed using the chi-square test and Fisher's exact test using SPSS version 18.0 (IBM Corp., Armonk, NY, USA). Results Overall, 35.8% of the DPRs studied showed the presence of STCs, including ossified stylohyoid complex (OSHC) (10.3%), thyroid cartilage (9.8%), tonsillolith (9.2%), atherosclerotic plaques (5.8%), calcified triticeous cartilage (CTC) (5.1%), sialolith (1.9%), as well as intra-articular (1.3%) and other calcifications (0.1-0.8%), i.e., calcified lymph node, antrolith, rhinolith, phlebolith, and osteoma cutis. STCs were found to be more prevalent in middle-aged patients and in females. A significant relationship was identified between the presence of carotid artery calcification and calcified superior horn of thyroid cartilage (CSHTC), as well as between the presence of CSHTC and CTC. Calcifications were detected either bilaterally (n = 2,003) or unilaterally (n = 2,388); however, OSHC mostly showed bilateral calcifications (8.5%). Conclusions Panoramic radiographs of dental patients reveal the frequent occurrence of STCs in the head and neck region with differing radiographic features. Certain calcifications show gender and age differences. Accurate detection of STCs may guide the identification of potential underlying diseases and help initiate referral to the relevant multidisciplinary teams.
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Affiliation(s)
- Aydan Acikgoz
- Department of Dentomaxillofacial Radiology, Yeni Yuzyil University, Faculty of Dentistry, Istanbul, TUR
| | - Ozlem Akkemik
- Department of Dentomaxillofacial Radiology, Baris Medical Imaging Center, Izmir, TUR
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Panwar A, Keluskar V, Charantimath S, Kumar S L, M S, T J. Bilateral elongated styloid process (Eagle’s syndrome) - a case report and short review. ACTA OTO-LARYNGOLOGICA CASE REPORTS 2022. [DOI: 10.1080/23772484.2022.2077206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Affiliation(s)
- Arun Panwar
- Department of Oral Medicine and Radiology, KAHER’s KLE Vishwanath Katti Institute of Dental Sciences, Belagavi, India
| | - Vaishali Keluskar
- Department of Oral Medicine and Radiology, KAHER’s KLE Vishwanath Katti Institute of Dental Sciences, Belagavi, India
| | - Shivayogi Charantimath
- Department of Oral Medicine and Radiology, KAHER’s KLE Vishwanath Katti Institute of Dental Sciences, Belagavi, India
| | - Lokesh Kumar S
- Department of Oral Medicine and Radiology, KAHER’s KLE Vishwanath Katti Institute of Dental Sciences, Belagavi, India
| | - Sridhar M
- Department of Oral Medicine and Radiology, KAHER’s KLE Vishwanath Katti Institute of Dental Sciences, Belagavi, India
| | - Jayapriya T
- Department of Oral Medicine and Radiology, KAHER’s KLE Vishwanath Katti Institute of Dental Sciences, Belagavi, India
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Jeyaraj P. Histopathological Analysis of Elongated Styloid Processes: A New Light on Etiopathogenesis of Eagle's Syndrome. Indian J Otolaryngol Head Neck Surg 2022; 74:4510-4520. [PMID: 36742717 PMCID: PMC9895455 DOI: 10.1007/s12070-021-02438-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 02/02/2021] [Indexed: 02/07/2023] Open
Abstract
There exists paucity in recorded literature on the detailed microscopic appearance of elongated styloid processes (ESPs) in patients with Eagle's syndrome (ES). Although literature is replete with numerous conflicting and inconclusive theories, the exact cause, mechanism of origin, development and progression of styloid apparatus enlargement remains unclear and ambiguous. To carry out detailed histopathogical examination of excised specimen of ESPs in a patient with ES, with the objective to determine its precise etiomorphogenesis, and to analyse the role of possible triggering factors. Light microscopic examination was carried out of the base, mid- and apical thirds of transorally excised ESPs in a 45-year-old patient with ES. Woven bone trabeculae were found emanating from tendinous insertions of the styloid group of muscles at the mid third of the ESPs. Apical region of the ESPs showed fibro-collagenous mesenchymal tissue with numerous, haphazardly scattered trabeculae of woven bone traversing it. Presence of deeply staining reversal lines all along the length of the ESPs was suggestive of multiple micro-fractures from recurrent traumatic/traction forces, and repeated attempts at repair and ossification. It is proposed that mesenchymal structures composing the stylohyoid ligament at its attachment, and tendinous insertions of styloid muscles into the ESPs are stimulated to undergo metaplastic alterations, by repetitive stress, traction or traumatic stimuli brought to bear upon them, from muscular contractions. This osseous metaplasia of connective cells within them, followed by dystrophic bone deposition, brings about SP thickening and lengthening with their attendant and associated clinico-pathological sequelae.
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Affiliation(s)
- Priya Jeyaraj
- Oral and Maxillofacial Surgery, Commanding Officer Military Dental Centre (Gough Lines), Secunderabad, India
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ALTINDAĞ A, EREN H, KÜÇÜKKALEM M, ALTINDAĞ Ö. Prevalence and Pattern of Stylohyoid Chain Complex on Panoramic Radiographs: A Retrospective Study. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2022. [DOI: 10.33808/clinexphealthsci.980990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
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
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Affiliation(s)
- Ali ALTINDAĞ
- NECMETTIN ERBAKAN UNIVERSITY, FACULTY OF DENTISTRY
| | - Hakan EREN
- Çanakkale Onsekiz Mart University, Faculty of Dentistry
| | | | - Ömer ALTINDAĞ
- Bilecik Şeyh Edebali University, Department of Statistics and Computer Sciences
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Farina R, Foti PV, Pennisi I, Conti A, Meli GA, Vasile T, Gozzo C, Tallamona E, Inì C, Palmucci S, Venturini M, Basile A. Stylo-Jugular Venous Compression Syndrome: Lessons Based on a Case Report. AMERICAN JOURNAL OF CASE REPORTS 2021; 22:e932035. [PMID: 34428194 PMCID: PMC8404167 DOI: 10.12659/ajcr.932035] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Eagle syndrome is a vascular compression syndrome that is caused by a very elongated styloid process and/or calcification of the stylohyoid ligament compressing the vascular or nerve structures of the neck, resulting in vascular congestion, thrombosis, or neurological symptoms (eg, dysphagia, neck pain, ear pain). Stylo-jugular venous compression syndrome is a subtype of Eagle syndrome and is caused by compression of the internal jugular vein. Treatment varies according to the symptoms and the severity of the compression, and it can be pharmacological or surgical, with vascular stenting and/or removal of the styloid process. We describe a rare case of left cerebral venous sinus thrombosis and ipsilateral internal jugular vein stenosis sustained by excessive length of the left styloid process. CASE REPORT A 36-year-old woman presented with recurrent episodes of drug-resistant headache and recent memory disturbances. She underwent cerebral and neck multidetector computed tomography-angiography and Doppler ultrasound of the epiaortic vessels that respectively revealed thrombosis of the left cerebral venous sinus and left internal jugular vein stenosis due to a very long styloid process. The patient was treated with anticoagulant drugs and experienced a gradual remission of symptoms. CONCLUSIONS Compression of the jugular vein by the styloid process is a rare entity, and it often goes undiagnosed when it is asymptomatic. Doppler ultrasound is a sensitive method for identifying jugular vein stenosis and can provide an estimated degree of stenosis, which is useful for treatment planning. Doppler ultrasound should be combined with multidetector computed tomography-angiography to rule out compression of other vascular structures and other causes of compression. Failure to treat these patients could have serious health consequences for them.
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Affiliation(s)
- Renato Farina
- Radiodiagnostic and Radiotherapy Unit, Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy
| | - Pietro Valerio Foti
- Radiodiagnostic and Radiotherapy Unit, Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy
| | - Isabella Pennisi
- Radiodiagnostic and Radiotherapy Unit, Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy
| | - Andrea Conti
- Radiodiagnostic and Radiotherapy Unit, Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", Catania University, Catania, Italy
| | - Gaetano A Meli
- Radiodiagnostic and Radiotherapy Unit, Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", Catania University, Catania, Italy
| | - Tiziana Vasile
- Radiodiagnostic and Radiotherapy Unit, Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", Catania University, Catania, Italy
| | - Cecilia Gozzo
- Radiodiagnostic and Radiotherapy Unit, Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", Catania University, Catania, Italy
| | - Eliana Tallamona
- Radiodiagnostic and Radiotherapy Unit, Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", Catania University, Catania, Italy
| | - Corrado Inì
- Radiodiagnostic and Radiotherapy Unit, Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", Catania University, Catania, Italy
| | - Stefano Palmucci
- Radiodiagnostic and Radiotherapy Unit, Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", Catania University, Catania, Italy
| | - Massimo Venturini
- Department of Diagnostic and Interventional Radiology, Circolo Hospital, Insubria University, Varese, Italy
| | - Antonio Basile
- Radiodiagnostic and Radiotherapy Unit, Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", Catania University, Catania, Italy
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Yucesoy T, Seker ED, Diker N, Unver T, Vardar F. The evaluation of the effect of hypercalcemia in oral pathologies. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2020; 122:7-12. [PMID: 33017686 DOI: 10.1016/j.jormas.2020.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 09/14/2020] [Accepted: 09/22/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Hypercalcemia is determined as an increase in the serum calcium level (above 10.5 mg/dL or ionized calcium is above 1.5 mmol/L). It was aimed to evaluate the effect of the increased serum calcium levels in dental panoramic radiographs with oral pathologies. MATERIALS & METHODS The final sample number of the present study was determined as 143. 61 patients with hypercalcemic calcium levels were grouped in Hypercalcemia Group (HPEG) whereas 82 patients were grouped in Normal Group. (NG) Measurements were performed only on the panoramic radiographs. The evaluated parameters were cyst-tumor or granuloma existence, sinus pneumatization, stylohyoid ligament calcifications, lamina dura loss, bone loss existence, etc. Statistical tests were carried out at p < 0.05 significance level. RESULTS The cyst-tumor formation (p = 0.03) and stylohyoid ligament calcification (p = 0.009) and increased radiopacity (p = 0.03) were significantly more common in NG than the HPEG group. Alveolar bone loss (p = 0.001) and periodontal defects (p = 0.01) were significantly more common in HPEG than the NG group. There was no significant relationship between other examined parameters. (p > 0.05) CONCLUSION: The serum calcium level revealed statistically significant outcomes and a close relationship with the pathologies occurring in the alveolar bone in the oral and maxillofacial region. However, it is highly recommended to include more patients in the newly planned studies and another bone-related biomarker should be evaluated simultaneously.
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Affiliation(s)
- Turker Yucesoy
- Bezmialem Vakif University, Faculty of Dentistry, Department of Oral & Maxillofacial Surgery, Istanbul, Turkey.
| | - Elif Dilara Seker
- Bezmialem Vakif University, Faculty of Dentistry, Department of Orthodontics, Istanbul, Turkey
| | - Nurettin Diker
- Bezmialem Vakif University, Faculty of Dentistry, Department of Oral & Maxillofacial Surgery, Istanbul, Turkey
| | - Tugba Unver
- Bezmialem Vakif University, Faculty of Dentistry, Department of Oral & Maxillofacial Radiology, Istanbul, Turkey
| | - Fatma Vardar
- Bezmialem Vakif University, Faculty of Dentistry, Istanbul, Turkey
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Czako L, Simko K, Thurzo A, Galis B, Varga I. The Syndrome of Elongated Styloid Process, the Eagle's Syndrome-From Anatomical, Evolutionary and Embryological Backgrounds to 3D Printing and Personalized Surgery Planning. Report of Five Cases. MEDICINA (KAUNAS, LITHUANIA) 2020; 56:E458. [PMID: 32916813 PMCID: PMC7558969 DOI: 10.3390/medicina56090458] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 09/04/2020] [Accepted: 09/07/2020] [Indexed: 11/28/2022]
Abstract
Background and Objectives: The symptoms of Eagle's syndrome are associated with the elongated styloid process of the temporal bone or calcification of the stylohyoid ligament. The first mention of pain syndrome associated with the elongated styloid process dates back to 1937, when it was described by Watt Weems Eagle. Over the last decade, experts in the field have shown a lively interest in the issue of the relationship between the elongated styloid process and various symptoms. This article presents the correlation between the clinical signs of Eagle's syndrome and alterations in surrounding anatomical structures. It includes a brief review of the evolutionary, embryological and clinical anatomical background of the elongated styloid process. Materials and Methods: Between 2018 and 2019, five patients were admitted to our workplace with 1-3-year history of bilateral or unilateral throat pain, otalgia and pharyngeal foreign body sensation. As a therapeutic novelty in the surgical approach to this condition, we used individual 3D printed models to measure and identify the exact location of the resection of the styloid process without damaging the surrounding anatomical structures, such as the facial, accessory, hypoglossal, and vagal nerves; the internal jugular vein; and the internal carotid artery. Results: Compared to traditional surgical methods without 3D models, 3D models helped to better identify cutting edges and major landmarks used in surgical treatment of Eagle's syndrome. Printed models provided assistance with the exact location of the styloid process resection position without damaging the surrounding anatomical structures such as the facial, accessory, hypoglossal, and vagal nerves; the internal jugular vein; and the internal carotid artery. Conclusion: In our clinical report, we used 3D printed models for navigation and planning during surgical procedures involving resections of the elongated styloid process. Additionally, we can formulate a new hypothesis: the elongated styloid process is a form of atavism of the bony hyoid apparatus in our evolutionary ancestors that is evolutionarily encoded or arises from disrupted degeneration of the middle portion of embryonal Reichert´s cartilage of the second pharyngeal arch. Under normal conditions, this portion does not ossify but degenerates and transforms into a connective tissue band, the future stylohyoid ligament.
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Affiliation(s)
- Ladislav Czako
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Comenius University in Bratislava and University Hospital, 81372 Bratislava, Slovakia; (K.S.); (B.G.)
| | - Kristian Simko
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Comenius University in Bratislava and University Hospital, 81372 Bratislava, Slovakia; (K.S.); (B.G.)
| | - Andrej Thurzo
- Department of Simulation and Virtual Medical Education, Faculty of Medicine, Comenius University in Bratislava, 81372 Bratislava, Slovakia;
| | - Branislav Galis
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Comenius University in Bratislava and University Hospital, 81372 Bratislava, Slovakia; (K.S.); (B.G.)
| | - Ivan Varga
- Institute of Histology and Embryology, Faculty of Medicine, Comenius University in Bratislava, 81372 Bratislava, Slovakia;
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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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Şener E, Gürhan C, Ceylan N, Güneri P. ELONGATION OR ANGULATION OF STYLOID PROCESS: DISCUSSION WITH A CASE REPORT AND REVIEW OF THE LITERATURE. CUMHURIYET DENTAL JOURNAL 2018. [DOI: 10.7126/cumudj.435368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Scavone G, Caltabiano DC, Raciti MV, Calcagno MC, Pennisi M, Musumeci AG, Ettorre GC. Eagle's syndrome: a case report and CT pictorial review. Radiol Case Rep 2018; 14:141-145. [PMID: 30405864 PMCID: PMC6218696 DOI: 10.1016/j.radcr.2018.10.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 10/14/2018] [Accepted: 10/14/2018] [Indexed: 11/27/2022] Open
Abstract
Eagle's syndrome (ES) refers to symptomatic elongation of the ossified styloid process. A styloid process greater than 2.5 cm in length should be considered abnormal; however, an elongated styloid process is not sufficient for a diagnosis of ES; only an abnormal styloid process in association with symptoms can confirm the syndrome. In this case report, we discuss a 54-year-old man who has come to our attention with various symptoms: dysphagia to both solids and liquids, difficulty swallowing, neck pain, and a foreign body sensation during bilateral neck rotation and mouth opening. The diagnosis is performed radiologically because conventional radiographs have many potential disadvantages, whereas, computed tomography (CT) scans and reconstructions allow the length and angulation of the styloid process to be measured and the relationship between the elongated styloid processes and adjacent anatomical structures to be evaluated. Moreover, CT allows for differential diagnosis and provides detailed information needed for surgical planning.
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Affiliation(s)
- Giovanni Scavone
- Department of diagnostic Radiology, Neuroradiology and interventional radiology, Hospital "Garibaldi", Piazza Santa Maria di Gesù, 5, Catania, CT 95124, Italy
| | - Daniele Carmelo Caltabiano
- Radiodiagnostic and Radiotherapy Unit, University Hospital "Policlinico Vittorio-Emanuele", Via Santa Sofia, 78, Catania CT 95124, Italy
| | - Maria Vittoria Raciti
- Radiodiagnostic Unit, University I.R.C.C.S. Policlinico "San Matteo", Viale Camillo Golgi, 19, Pavia, PV 27100, Italy
| | - Maria Carla Calcagno
- Radiodiagnostic and Radiotherapy Unit, University Hospital "Policlinico Vittorio-Emanuele", Via Santa Sofia, 78, Catania CT 95124, Italy
| | - Monica Pennisi
- Radiodiagnostic and Radiotherapy Unit, University Hospital "Policlinico Vittorio-Emanuele", Via Santa Sofia, 78, Catania CT 95124, Italy
| | - Andrea Giovanni Musumeci
- Radiodiagnostic and Radiotherapy Unit, University Hospital "Policlinico Vittorio-Emanuele", Via Santa Sofia, 78, Catania CT 95124, Italy
| | - Giovanni Carlo Ettorre
- Radiodiagnostic and Radiotherapy Unit, University Hospital "Policlinico Vittorio-Emanuele", Via Santa Sofia, 78, Catania CT 95124, Italy
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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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13
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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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Hernández G, Plaza SP, Cifuentes D, Villalobos LM, Ruiz LM. Incidental findings in pre-orthodontic treatment radiographs. Int Dent J 2018; 68:320-326. [PMID: 29607488 DOI: 10.1111/idj.12389] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES To determine the frequency, radiodensity characteristics, topographic location and number per patient of incidental findings observed in radiographs taken before orthodontic treatment and to evaluate the relationship of the findings with age and sex. METHODS This was a cross-sectional study that investigated 1,887 panoramic and lateral cephalogram radiographs from 783 patients (23.31 ± 13.11 years of age; 453 women and 330 men) who were randomly selected from the orthodontics department of a private university. The images were systematically evaluated by an oral pathologist. A chi-square test was applied to evaluate the association between sex and the presence of pathology, radiodensity characteristics and topographic location. The Mann-Whitney U and Kruskal-Wallis tests were used to establish the association between age or number of findings per patient with other variables in the study. RESULTS The prevalence of incidental findings was 88.12%. The most frequent finding was maxillary sinus pneumatisation (25.80%). No significant association was detected between frequency or number of findings per patient and either sex or diagnostic hypothesis. A significant association was found between age and the presence of pathology and number of incidental findings per patient (P < 0.001), as well as between the type of radiographic image and incidental finding (P < 0.001). CONCLUSION The prevalence of incidental findings in the sample studied was high, and the structures most commonly involved were the maxillary sinuses. The results suggest that both the presence and the number of findings per patient increase with age but there is no association with sex.
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Kratz RJ, Walton JN, MacEntee MI, Nguyen CT, MacDonald D. Panoramic radiographs made before complete removable dental prostheses fabrication: A retrospective study of clinical significance. J Prosthet Dent 2016; 118:26-30. [PMID: 28024823 DOI: 10.1016/j.prosdent.2016.09.034] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 09/13/2016] [Accepted: 09/13/2016] [Indexed: 11/26/2022]
Abstract
STATEMENT OF PROBLEM The value of digital panoramic radiographs to screen for problems before fabricating conventional complete dentures is unclear. PURPOSE The purpose of this retrospective study was to examine the influence of pretreatment digital panoramic radiographs on the clinical management of patients receiving complete removable dental prostheses. MATERIAL AND METHODS The clinical records, including panoramic radiographs, of 169 patients seeking new complete removable dental prostheses over a 6-year period were interpreted independently by both a prosthodontist and an oral and maxillofacial radiologist to identify radiographic findings that influenced clinical patient management. A 95% confidence interval and an observed proportion of agreement were used to interpret the results. RESULTS Sixty percent of the 169 radiographs examined had 1 or more abnormal or positive radiographic findings; however, only 6 (<4%) of 165 abnormalities detected influenced patient management, and 3 of them were identified during the clinical examination. CONCLUSIONS Pretreatment digital panoramic radiographs revealed very few abnormalities that influenced the treatment of patients requiring complete removable dental prostheses. Furthermore, the digital images in this study revealed positive findings at a rate similar to those found in studies assessing analog radiographs, reinforcing current guidelines that recommend against radiographic screening of patients who seek new complete removable dental prostheses.
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Affiliation(s)
| | - Joanne N Walton
- Professor Emeritus, Division of Prosthodontics and Dental Geriatrics, Department of Oral Health Sciences, University of British Columbia Faculty of Dentistry, Vancouver, BC, Canada
| | - Michael I MacEntee
- Professor Emeritus, Division of Prosthodontics and Dental Geriatrics, Department of Oral Health Sciences, University of British Columbia Faculty of Dentistry, Vancouver, BC, Canada
| | - Caroline T Nguyen
- Assistant Professor, Division of Prosthodontics and Dental Geriatrics, Department of Oral Health Sciences, University of British Columbia Faculty of Dentistry, Vancouver, BC, Canada; and Provincial Practice Leader in Prosthodontics, Department of Dentistry and Oral Oncology, British Columbia Cancer Agency, Vancouver, BC, Canada
| | - David MacDonald
- Associate Professor and Chair, Division of Oral and Maxillofacial Radiology, Department of Oral, Biological and Medical Sciences, University of British Columbia Faculty of Dentistry, Vancouver, BC, Canada
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Abstract
Eagle syndrome is a rare condition resulting from elongation of the temporal styloid process or calcification of its associated stylohyoid ligaments. Although usually presenting with pain or odynophagia, Eagle syndrome has been reported to cause a multitude of neurologic symptoms or vascular complications, some of which can be life-threatening. We present a case in which an endovascularly placed internal carotid artery stent in close proximity to a calcified stylohyoid ligament resulted in stent fracture with subsequent stent and vessel occlusion. We review and discuss the presentation, diagnosis, etiology, complications and treatment options of the syndrome.
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Affiliation(s)
- Jeffrey D Hooker
- Department of Radiology, University of Mississippi Medical Center, Jackson, MS, USA
| | - David A Joyner
- Department of Radiology, University of Mississippi Medical Center, Jackson, MS, USA
| | - Edward P Farley
- Department of Radiology, University of Mississippi Medical Center, Jackson, MS, USA
| | - Majid Khan
- Department of Radiology, University of Mississippi Medical Center, Jackson, MS, USA
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Does the state of dentition effect the type of stylohyoid chain calcification pattern? Surg Radiol Anat 2016; 38:817-23. [PMID: 26780778 DOI: 10.1007/s00276-016-1624-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 01/07/2016] [Indexed: 10/22/2022]
Abstract
INTRODUCTION The human stylohyoid chain calcification patterns (SCP) present considerable anatomic variability. This study was performed to investigate the calcification on SCP in the dentate and total edentulous population and its relation to mandibular protrusive movement. MATERIALS AND METHODS The study analyzed 1.234 SCP in digital panoramic radiographs of 617 subjects. The SCP were classified according to Mac Donald-Jankowski. The amount of mandibular protrusion movement limitation was evaluated for each subject. The data were analyzed using one-way Anova, Kruskall Wallis, Mann-Whitney U, and Chi-squared tests with significance set at p = 0.05. RESULTS Among the 617 subjects evaluated there was symmetry of the SCP between the left and right sides in 87.3 % of the cases. In the study population 501 subjects were dentate (Class I, Class II, Class III molar relationship) and 116 subjects were total edentulous. There were significant differences among dentate and total edentulous patients for the distribution of SCP (p < 0.05). Elongated group was more prevalent in total edentulous subjects while in subjects with Class I occlusion normal SCP was observed. Although mandibular protrusive movement range was within normal limits for all the groups, calcified and elongated groups have numerically less protrusive movement compared to normal groups (p < 0.05). CONCLUSION Among dentate and total edentulous subjects, similarity in SCP for right and left side was observed. The elongation of SCP was more common in the total edentulous group. Further studies conducted on larger populations are necessary to establish the effect of the state of dentition on the SCP.
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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: 17] [Impact Index Per Article: 1.9] [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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Morphometric Analysis of Styloid Process Using Multidetector Computed Tomography. J Craniofac Surg 2015; 26:e438-43. [DOI: 10.1097/scs.0000000000001888] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Sekerci AE, Soylu E, Arikan MP, Aglarci OS. Is there a relationship between the presence of ponticulus posticus and elongated styloid process? Clin Imaging 2015; 39:220-4. [DOI: 10.1016/j.clinimag.2014.11.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 11/17/2014] [Accepted: 11/18/2014] [Indexed: 11/26/2022]
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Calcification of the stylohyoid ligament in panoramic radiography and cone beam computed tomography among patients referred for dental implant treatment planning. IMPLANT DENT 2014; 23:508-13. [PMID: 25033348 DOI: 10.1097/id.0000000000000125] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Calcification of the stylohyoid ligament (SHL) is a common condition noted as an incidental finding in routine radiographic examination. Due to proximity with important neurovascular structures, elongation and calcification may sometimes lead to dysphagia and pain. The objective of this study was to evaluate the incidence of calcified SHL detected on cone beam computed tomography (CBCT) scans and panoramic radiographs (PR) in patients referred for dental implant therapy. METHODS Retrospective analysis of 30 patients referred for dental implants to the Department of Oral and Maxillofacial Radiology at the University of Connecticut School of Dental Medicine was done. Patients were imaged using Hitachi CB MercuRay CBCT machine, and PRs were obtained using Planmeca panoramic machine. CBCT reconstructions and panoramic images were evaluated for the incidence and pattern of SHL calcification. RESULTS Nineteen patients (63.3%) had calcified SHLs, 16 of whom were reported to have bilateral involvement. PR was unable to show complete calcification of the ligament in any of the cases, whereas CBCT showed evidence of complete calcification when present (14 cases). CONCLUSION CBCT was more accurate in determining the pattern and extent of calcification of the SHL in patients undergoing implant treatment planning.
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Guimarães AS, Pozza DH, de Castro IC, Galdames ICS, Palla S. Complete ossification of the stylohyoid chain as cause of Eagle's syndrome: a very rare case report. J Contemp Dent Pract 2014; 15:500-5. [PMID: 25576120 DOI: 10.5005/jp-journals-10024-1569] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM To report on a patient with Eagle's syndrome with a complete and very large ossification of the stylohyoid complex on the right side that to our best knowledge has never been published previously. BACKGROUND Eagle's syndrome is characterized by a set of symptoms that are caused by the irritation of the neurovascular and soft-tissues caused by an elongated styloid process or ossification of stylohyoid ligament. CASE DESCRIPTION Because of the high discomfort and pain degree as well as limitations of mandibular and head mobility and also the thickness of the ossifed stylohyoid chain, the patient was treated surgically by removing the hypertrophic segment. CONCLUSION These symptoms subsided completely after the surgical excision of the anomaly. The elongated styloid process on the left side was symptom free. CLINICAL SIGNIFICANCE Eagle's syndrome symptoms are not specific and can mimic those of other disorders, the syndrome must be included in the differential diagnosis of patients with pain in the orofacial, pharyngeal and cervical area.
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Affiliation(s)
- Antônio Sárgio Guimarães
- Professor and Head, Department of TMD and Orofacial Pain Clinical, Dental Research Institute, Sao Leopoldo Mandic, Brazil
| | - Daniel Humberto Pozza
- Professor, Department of Experimental Biology, Faculty of Medicine University of Porto, Porto, Portugal, e-mail:
| | - Idercy Cabral de Castro
- Dentist, Department of TMD and Orofacial Pain Clinical, Dental Research Institute, Sao Leopoldo Mandic, Brazil
| | | | - Sandro Palla
- Retired Professor and Head, Department of Masticatory Disorders, Center of Dental Medicine, University of Zurich, Switzerland
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Unilateral complete articulated ossification of the stylohyoid apparatus: case report and review of the literature. Surg Radiol Anat 2014; 36:941-5. [DOI: 10.1007/s00276-014-1328-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2013] [Accepted: 06/12/2014] [Indexed: 11/25/2022]
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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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Alpoz E, Akar GC, Celik S, Govsa F, Lomcali G. Prevalence and pattern of stylohyoid chain complex patterns detected by panoramic radiographs among Turkish population. Surg Radiol Anat 2013; 36:39-46. [DOI: 10.1007/s00276-013-1137-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Accepted: 05/08/2013] [Indexed: 10/26/2022]
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Sudhakara Reddy R, Sai Kiran C, Sai Madhavi N, Raghavendra MN, Satish A. Prevalence of elongation and calcification patterns of elongated styloid process in south India. J Clin Exp Dent 2013; 5:e30-5. [PMID: 24455048 PMCID: PMC3892225 DOI: 10.4317/jced.50981] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2012] [Accepted: 11/10/2012] [Indexed: 11/19/2022] Open
Abstract
Objective: Very few studies have been reported in the literature classifying the elongation and calcification patterns of styloid process. The present study was done to investigate the prevalence of elongation and calcification patterns of styloid process in patients attending a dental institution in south India.
Study design: 600 digital panoramic radiographs of patients with dental problems were obtained from the outpatient department of the Dental institution. The apparent length of the styloid process was measured by a single experienced oral radiologist, with the help of the measuring tools on the accompanying software. The type of elongation and calcification patterns of each elongated styloid process was classified as per Langlai’s classification with few modifications. Finally the data was subjected to statistical analysis.
Results: Out of 520 measurable styloid processes (260 panoramic radiographs), 154 styloid processes had length greater than 3cm. The mean average length of elongated styloid process was 3.67±0.62 cm. No significant association was obtained between age and length of styloid process. In present study, the type of elongation pattern has no effect on the calcification pattern. Our results suggested that Type I elongated styloid processes were most likely to be completely calcified (type D), but statistically not significant.
Conclusion: Type I pattern of elongation was found to be more prevalent in elder age group and was completely calcified in most of the cases. Interestingly, only three patients (out of 260) showed symptomatic elongation of styloid process. A relatively high prevalence of type IV elongation pattern (9 /154) was obtained in the present study, when compared to type III styloid process. Further large scale imaging studies are required to evaluate the presence of type IV elongation pattern in various population groups.
Key words:Eagle’s syndrome, Elongated styloid process, Stylopharyngeous muscle, Tonsillectomy.
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Affiliation(s)
- R Sudhakara Reddy
- Professor and HOD. Department of Oral Medicine and Radiology, Vishnu Dental college, Bhimavaram
| | - Ch Sai Kiran
- Postgraduate. Department of Oral Medicine and Radiology, Vishnu Dental College, Bhimavaram
| | - N Sai Madhavi
- Postgraduate. Department of Oral Medicine and Radiology, Vishnu Dental College, Bhimavaram
| | - M N Raghavendra
- Senior Lecturer, Department of oral medicine and radiology,Vishnu Dental College, Bhimavaram
| | - A Satish
- Postgraduate. Department of Oral Medicine and Radiology, Vishnu Dental College, Bhimavaram
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Roopashri G, Vaishali MR, David MP, Baig M. Evaluation of elongated styloid process on digital panoramic radiographs. J Contemp Dent Pract 2012; 13:618-622. [PMID: 23250163 DOI: 10.5005/jp-journals-10024-1197] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND AND OBJECTIVE The elongated styloid process may produce characteristic head and neck pain syndromes, commonly known as Eagle's syndrome. An awareness of this syndrome is important to all health practitioners involved in the diagnosis and treatment of neck and head pain. It has been estimated that 2 to 28% of the general adult population has radiographic appearance of elongated styloid process. The objective of the study was to assess the elongation of styloid process on digital panoramic radiographs and to evaluate the prevalence of elongation according to age, sex and types. RESULTS Elongated styloid process was seen in 107 subjects out of 300 patients who were aged between 10 and 70 years old. Our study revealed that as age increased elongation of styloid process increased with female predominance. Type 1 elongation was most common than the other types of elongation. We also found that left styloids were elongated than the right with bilateral elongation. CONCLUSION Panoramic radiographs can show a correct picture of elongated styloid process which can confirm the diagnosis and can thus help avoid misinterpretation of the symptoms as tonsillar pain or pain of dental, pharyngeal or muscular origin and hence panoramic radiography is economical and the best imaging modality to view the elongation of styloid process.
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Affiliation(s)
- G Roopashri
- Department of Oral Medicine and Radiology MR Ambedkar Dental College and Hospital, Bengaluru, Karnataka, India.
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Kim JE, Min JH, Park HR, Choi BR, Choi JW, Huh KH. Severe calcified stylohyoid complex in twins: a case report. Imaging Sci Dent 2012; 42:95-7. [PMID: 22783478 PMCID: PMC3389056 DOI: 10.5624/isd.2012.42.2.95] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2012] [Revised: 02/02/2012] [Accepted: 02/20/2012] [Indexed: 11/24/2022] Open
Abstract
The styloid process is a cylindrical, long cartilaginous bone located on the temporal bone. The calcified stylohyoid ligament and elongated styloid process can be identified radiographically, and they are associated with a number of syndromes and symptoms. The exact cause of the styloid process elongation due to calcification and subsequent ossification of ligament is unclear. This report presents a case of severely calcified stylohyoid ligament complex occurred in twins who have the same pattern of calcification.
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Affiliation(s)
- Jo-Eun Kim
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
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Öztaş B, Orhan K. Investigation of the incidence of stylohyoid ligament calcifications with panoramic radiographs. ACTA ACUST UNITED AC 2011; 3:30-5. [PMID: 22298518 DOI: 10.1111/j.2041-1626.2011.00081.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Bengi Öztaş
- Department of Oral Diagnosis and Radiology, Faculty of Dentistry, Ankara University, Beşevler, Ankara, Turkey.
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Watanabe PCA, Dias FC, Issa JPM, Monteiro SAC, de Paula FJA, Tiossi R. Elongated styloid process and atheroma in panoramic radiography and its relationship with systemic osteoporosis and osteopenia. Osteoporos Int 2010; 21:831-6. [PMID: 19629615 DOI: 10.1007/s00198-009-1022-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2009] [Accepted: 07/06/2009] [Indexed: 10/20/2022]
Abstract
UNLABELLED Association between the presence of an elongated styloid process, vascular calcification (atheroma) and the potential risk factor for osteoporosis was studied. Presence of an elongated styloid process was found to be correlated with systemic osteoporosis and also between elongated styloid process and atheroma. INTRODUCTION The association between the presences of an elongated styloid process and vascular calcification (atheroma) with the potential risk factor assessment for osteoporosis was studied. METHODS Bone mineral density obtained by dual energy X-ray absorptiometry diagnosed osteopenia/osteoporosis on at least two of three sites (column, hips, and forearm) of 50 female patients. Panoramic maxillomandibular radiographs were taken and analyzed. Elongation of the styloid processes was measured and the presence of atheromas in the carotid was investigated. RESULTS Eighty percent of the patients presented at least one side with elongated styloid process and the highest prevalence (87.5%) occurred in individuals between 60 and 69 years. Atheroma was found in four patients, three of which presented elongated styloid on at least one side and had diagnosed osteoporosis on at least two of the evaluated sites. CONCLUSIONS Correlation was found between the elongation of the styloid process and systemic osteoporosis, and between elongated styloid process and atheroma. The method in this study might be used as part of a method for osteopenia/osteoporosis and atheroma risk assessment.
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Affiliation(s)
- P C A Watanabe
- Department of Morphology, Stomatology and Physiology, School of Dentistry, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
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Piagkou M, Anagnostopoulou S, Kouladouros K, Piagkos G. Eagle's syndrome: a review of the literature. Clin Anat 2009; 22:545-58. [PMID: 19418452 DOI: 10.1002/ca.20804] [Citation(s) in RCA: 113] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Eagle's syndrome represents symptoms brought on by compression of regional structures by elongation of the styloid process or ossification of the stylohyoid or stylomandibular ligaments. Watt Eagle described it for the first time in 1937, dividing it into two subtypes: the "classic syndrome" and the "stylo-carotid artery syndrome." Many theories have been put forth regarding its pathogenesis. Depending on the underlying pathogenetic mechanism and the anatomical structures compressed or irritated by the styloid process, symptoms vary greatly, ranging from cervicofacial pain to cerebral ischemia. The syndrome generally follows tonsillectomy or trauma. Diagnosis is confirmed by radiological findings. Palpation of the styloid process in the tonsillar fossa and infiltration with anesthesia are also used in making the diagnosis. The treatment is primarily surgical; however, some conservative treatments have also been used. The current literature on Eagle's syndrome is reviewed, highlighting its often underestimated frequency and its clinical importance.
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Affiliation(s)
- Maria Piagkou
- Department of Anatomy, Medical School, University of Athens, Athens, Greece.
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Investigation of elongated styloid process prevalence in patients with torus palatinus. Clin Oral Investig 2008; 13:269-72. [DOI: 10.1007/s00784-008-0232-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2008] [Revised: 10/13/2008] [Accepted: 10/14/2008] [Indexed: 10/21/2022]
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Okabe S, Morimoto Y, Ansai T, Yoshioka I, Tanaka T, Taguchi A, Kito S, Wakasugi-Sato N, Oda M, Kuroiwa H, Ohba T, Awano S, Takata Y, Takehara T. Assessment of the relationship between the mandibular cortex on panoramic radiographs and the risk of bone fracture and vascular disease in 80-year-olds. ACTA ACUST UNITED AC 2008; 106:433-42. [PMID: 18299222 DOI: 10.1016/j.tripleo.2007.09.013] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2007] [Revised: 09/04/2007] [Accepted: 09/08/2007] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The objective of this study was to assess cortical measurements on panoramic radiographs in 80-year-old subjects to predict bone fracture and vascular disease risks. METHODS The cortical width and shape (normal cortex, mildly to moderately eroded cortex, and severely eroded cortex) were evaluated on 659 panoramic radiographs obtained from 262 men and 397 women, all of whom were 80 years old. At baseline, a general medical examination, including heel bone density, was performed in all subjects. Fractures and vascular disease occurring within 5 years after the baseline examination were determined in 191 subjects and in 108 subjects who died within 5 years after the baseline examination. RESULTS There were significant correlations between heel bone density and cortical width (r = 0.435, P < .001) and shape (r = 0.231, P < .001). However, cortical measurements on panoramic radiographs were not significantly associated with the occurrence of fractures and vascular disease within 5 years after the baseline examination. CONCLUSIONS Among the elderly, cortical measurements on panoramic radiographs may be associated with bone mineral density and physical activity, but they are not useful markers for the subsequent occurrence of fractures and vascular disease.
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Affiliation(s)
- Sachiko Okabe
- Department of Oral Diagnostic Science, Kyushu Dental College, Kitakyushu, Japan
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