Eagle syndrome

Possible symptoms include: Classic Eagle syndrome is present on only one side; however, it may rarely be present on both sides. ==Cause==

Eagle syndrome occurs due to elongation of the styloid process or calcification of the stylohyoid ligament, potentially compressing the nearby carotid artery or glossopharyngeal nerve. There are reports of Eagle syndrome induced by wisdom tooth removal. ==Diagnosis==

File:Eagle-Syndrom Roe seitlich 002.jpg|Radiograph, lateral view showing elongated stylohyoid process and stylohyoid ligament ossification File:Processus styloideus.jpg|Radiograph, lateral view showing joint-like formation in ossified stylohyoid ligament File:Ossifikationen im Ligamentum stylohyoideom beidseits - Eagle-Syndrom - CT cor 001.jpg|CT scan, coronal section showing bilateral extended styloid process and stylohyoid ligament ossification (incidental finding) File:Verknoechertes Lig stylohyoideum - CT 3D.jpg|3D-reconstructed CT scan showing bilateral stylohyoid ligament ossification Proc styloideus.JPG|3D reconstructed CT scan showing elongated styloid process (right side) Diagnosis is suspected when a patient presents with the symptoms of the classic form of "Eagle syndrome" e.g. unilateral neck pain, sore throat or tinnitus. Sometimes the tip of the styloid process is palpable in the back of the throat. The diagnosis of the vascular type is more difficult and requires an expert opinion. One should have a high level of suspicion when neurological symptoms occur upon head rotation. Symptoms tend to be worsened on bimanual palpation of the styloid through the tonsillar bed. They may be relieved by infiltration of lidocaine into the tonsillar bed. Because of the proximity of several large vascular structures in this area this procedure should not be considered to be risk free. Imaging is important and is diagnostic. Visualizing the styloid process on a CT scan with 3D reconstruction is the suggested imaging technique. The enlarged styloid may be visible on an orthopantogram or a lateral soft tissue X ray of the neck. ==Treatment==

Treatment for Eagle syndrome varies by case severity. Conservative methods typically include physiotherapy, long-acting anesthetics, and anti-inflammatory drugs. More specifically NSAIDs, anticonvulsants, and antidepressants. NSAIDs are beneficial for inflammatory symptoms, while other medications target nerve-related pain. Studies have shown that consistent physical therapy can significantly reduce pain and improve quality of life for patients with Eagle Syndrome. ==Epidemiology==

Approximately 4% of the general population have an elongated styloid process, and of these about 4% give rise to the symptoms of Eagle syndrome. Studies have reported the incidence of styloid elongation in patients presenting with orthofacial pain to be as high as 54%. Patients with this syndrome tend to be between 30 and 50 years of age but it has been recorded in teenagers and in patients > 75 years old. It is more common in women, with a male:female ratio ~ 1:2. == See also ==