Eagle syndrome. A narrative review.
Abstract
Painful disorders in the maxillofacial region are common in dental practice. Most of these conditions are not properly diagnosed because of inadequate knowledge of craniofacial and cervico-pharyngeal syndromes such as Eagle Syndrome. The aim of this review is to describe the general aspects, diagnosis and treatment of Eagle syndrome. Eagle syndrome or stylohyoid syndrome was first described by Watt W. Eagle in 1937. It was defined as orofacial pain related to the elongation of the styloid process and ligament stylohyoid calcification. The condition is accompanied by symptoms such as dysphonia, dysphagia, sore throat, glossitis, earache, tonsillitis, facial pain, headache, pain in the temporomandibular joint and inability to perform lateral movements of the neck. Diagnosis and treatment of Eagle syndrome based on symptoms and radiographic examination of the patient will determine the need for surgical or nonsurgical treatment. Eagle syndrome is a complex disorder demanding a thorough knowledge of its signs and symptoms to make a correct diagnosis and provide an appropriate subsequent treatment. Disseminating information about this syndrome among medical-dental professionals is essential to provide adequate dental care to patients.
References
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2. Piagkou M, Anagnostopoulou S, Kouladouros K, Piagkos G. Eagle's syndrome: a review of the literature. Clin Anat. 2009;22(5):545–58.
3. Mayrink G, Figueiredo EP, Sato FR, Moreira RW. Cervicofacial pain associated with Eagle's syndrome misdiagnosed as trigeminal neuralgia. Oral Maxillofac Surg. 2012;16(2):207–10.
4. Raffo Lirios M. Síndrome Eagle: reporte de un caso. Odontoestomatología. 2012;14(20):26–31.
5. Eagle WW. Elongated styloid processes. Report of Two Cases. Arch Otolaryngol. 1937;25(5):584–7.
6. Singhania AA, Chauhan NV, George A, Rathwala K. Lidocine Infiltration Test: An Useful Test in the Prediction of Results of Styloidectomy for Eagle's Syndrome. Indian J Otolaryngol Head Neck Surg. 2013;65(1):20–3.
7. Kosar MI, Atalar MH, Sabancioğullari V, Tetiker H, Erdil FH, Cimen M, Otağ I. Evaluation of the length and angulation of the styloid process in the patient with pre-diagnosis of Eagle syndrome. Folia Morphol (Warsz) 2011;70(4):295–9.
8. Cullu N, Deveer M, Sahan M, Tetiker H, Yilmaz M. Radiological evaluation of the styloid process length in the normal population. Folia Morphol (Warsz) 2013;72(4):318–21.
9. Vadgaonkar R, Murlimanju BV, Prabhu LV, Rai R, Pai MM, Tonse M, Jiji PJ. Morphological study of styloid process of the temporal bone and its clinical implications. Anat Cell Biol. 2015;48(3):195–200.
10. Roopashri G, Vaishali MR, David MP, Baig M. Evaluation of elongated styloid process on digital panoramic radiographs. J Contemp Dent Pract. 2012;13(5):618–22.
11. Patil S, Ghosh S, Vasudeva N. Morphometric study of the styloid process of temporal bone. J Clin Diagn Res. 2014;8(9):AC04–6.
12. Zeckler SR, Betancur AG, Yaniv G. The eagle is landing: Eagle syndrome--an important differential diagnosis. Br J Gen Pract. 2012;62(602):501–2.
13. Gupta N. Diagnosis and management of Eagle’s syndrome: a clinical review. Asian J Mod Ayurvedic Med Sci. 2012;1(1):1–7.
14. Romero JG, Nieto MAM, Sánchez AAR. Eagle’s syndrome. Patient handling at the «Licenciado Adolfo López Mateos» Hospital Mexico City. Rev Odont Mex. 19(4):e254–8.
15. Phulambrikar T, Rajeshwari A, Rao BB, Warhekar AM, Reddy P. Incidence of elongated styloid process: a radiographic study. J Indian Acad Oral Med Radiol. 2011;23(3):S344–6.
16. Colby CC, Del Gaudio JM. Stylohyoid complex syndrome: a new diagnostic classification. Arch Otolaryngol Head Neck Surg. 2011;137(3):248–52.
17. Santini L, Achache M, Gomert R, Mardassi A, Lafont B, Magnan J, Lavieille JP, Devèze A. Transoral surgical treatment of Eagle's syndrome: case report and review of literature. Rev Laryngol Otol Rhinol (Bord) 2012;133(3):141–4.
18. Öztaş B, Orhan K. Investigation of the incidence of stylohyoid ligament calcifications with panoramic radiographs. J Investig Clin Dent. 2012;3(1):30–5.
19. Fusco DJ, Asteraki S, Spetzler RF. Eagle's syndrome: embryology, anatomy, and clinical management. Acta Neurochir (Wien) 2012;154(7):1119–26.
20. Andrei F, Motoc AG, Didilescu AC, Rusu MC. A 3D cone beam computed tomography study of the styloid process of the temporal bone. Folia Morphol (Warsz) 2013;72(1):29–35.
21. Spalthoff S, Zimmerer R, Dittmann O, Tavassol F, Dittmann J, Gellrich NC, Jehn P. Piezoelectric surgery and navigation: a safe approach for complex cases of Eagle syndrome. Int J Oral Maxillofac Surg. 2016;pii: S0901-5027(16):30068–6.
22. Kim SM, Seo MH, Myoung H, Choi JY, Kim YS, Lee SK. Osteogenetic changes in elongated styloid processes of Eagle syndrome patients. J Craniomaxillofac Surg. 2014;42(5):661–7.
23. Shaik MA, Naheeda , Kaleem SM, Wahab A, Hameed S. Prevalence of elongated styloid process in Saudi population of Aseer region. Eur J Dent. 2013;7(4):449–54.
24. Sudhakara Reddy R, Sai Kiran Ch, 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(1):e30–5.
25. Hoffmann E, Räder C, Fuhrmann H, Maurer P. Styloid-carotid artery syndrome treated surgically with Piezosurgery: a case report and literature review. J Craniomaxillofac Surg. 2013;41(2):162–6.
26. Yavuz H, Caylakli F, Erkan AN, Ozluoglu LN . Modified intraoral approach for removal of an elongated styloid process. J Otolaryngol Head Neck Surg. 2011;40(1):86–90.
27. Scheller K, Eckert AW, Scheller C. Transoral, retromolar, para-tonsillar approach to the styloid process in 6 patients with Eagle's syndrome. Med Oral Patol Oral Cir Bucal. 2014;19(1):e61–6.
28. Dou G, Zhang Y, Zong C, Chen Y, Guo Y, Tian L. Application of surgical navigation in styloidectomy for treating Eagle's syndrome. Ther Clin Risk Manag. 2016;12:575–83.
29. Yasmeenahamed S, Laliytha BK, Sivaraman S, Ambiga P, Dineshshankar J, Sudhaa M. Eagle's syndrome - Masquerading as ear pain: Review of literature. J Pharm Bioallied Sci. 2015;7(Suppl 2):S372–3.
30. Migliario M, Lucchina AG, Francone S, Renò F, Mortellaro C. Elongated styloid process (Eagle’s Syndrome) causing orofacial pain. Int J Clin Dent. 2011;4(4):375–81.
31. Al Weteid AS, Miloro M. Transoral endoscopic-assisted styloidectomy: How should Eagle syndrome be managed surgically? Int J Oral Maxillofac Surg. 2015;44(9):1181–7.
32. Permpalung N, Suksaranjit P, Chongnarungsin D, Hyman CL. Unveiling the hidden eagle: acute parotitis-induced eagle syndrome. N Am J Med Sci. 2014;6(2):102–4.
33. Bagga MB, Kumar CA, Yeluri G. Clinicoradiologic evaluation of styloid process calcification. Imaging Sci Dent. 2012;42(3):155–61.
34. Anbiaee N, Javadzadeh A. Elongated styloid process: is it a pathologic condition? Indian J Dent Res. 2011;22(5):673–7.
35. Keur JJ, Campbell JP, McCarthy JF, Ralph WJ. The clinical significance of the elongated styloid process. Oral Surg Oral Med Oral Pathol. 1986;61(4):399–404.
36. Abdel-Ghany AF, Osman NM. Role of three-dimensional multidetector computerized tomography in diagnosis of Eagle's syndrome. Egypt J Radiol Nucl Med. 2014;45:105–8.
37. Vieira EM, Guedes OA, Morais SD, Musis CR, Albuquerque PA, Borges ÁH. Prevalence of Elongated Styloid Process in a Central Brazilian Population. J Clin Diagn Res. 2015;9(9):ZC90–2.
38. Kaufman SM, Elzay RP, Irish EF. Styloid process variation. Radiologic and clinical study. Arch Otolaryngol. 1970;91(5):460–3.
39. Lindeman P. The elongated styloid process as a cause of throat discomfort. Four case reports. J Laryngol Otol. 1985;99(5):505–8.
40. Langlais RP, Miles DA, Van Dis ML. Elongated and mineralized stylohyoid ligament complex: a proposed classification and report of a case of Eagle's syndrome. Oral Surg Oral Med Oral Pathol. 1986;61(5):527–32.
41. de Andrade KM, Rodrigues CA, Watanabe PC, Mazzetto MO. Styloid process elongation and calcification in subjects with tmd: clinical and radiographic aspects. Braz Dent J. 2012;23(4):443–50.
42. Sharma V, Bajwa SJ. The potential role of dexmeditomidine during perioperative period in a hypertensive patient with Eagle syndrome. Anesth Essays Res. 2013;7(3):423–4.
43. Morrison PJ, Morrison RJ, McKinstry CS. Familial ossification of the stylohyoid ligament in a three generation family--a new clinical entity displaying autosomal dominant inheritance. Br J Radiol. 2012;85(1012):458–9.
44. Todo T, Alexander M, Stokol C, Lyden P, Braunstein G, Gewertz B. Eagle syndrome revisited: cerebrovascular complications. Ann Vasc Surg. 2012;26(5):729–e1-5.
2. Piagkou M, Anagnostopoulou S, Kouladouros K, Piagkos G. Eagle's syndrome: a review of the literature. Clin Anat. 2009;22(5):545–58.
3. Mayrink G, Figueiredo EP, Sato FR, Moreira RW. Cervicofacial pain associated with Eagle's syndrome misdiagnosed as trigeminal neuralgia. Oral Maxillofac Surg. 2012;16(2):207–10.
4. Raffo Lirios M. Síndrome Eagle: reporte de un caso. Odontoestomatología. 2012;14(20):26–31.
5. Eagle WW. Elongated styloid processes. Report of Two Cases. Arch Otolaryngol. 1937;25(5):584–7.
6. Singhania AA, Chauhan NV, George A, Rathwala K. Lidocine Infiltration Test: An Useful Test in the Prediction of Results of Styloidectomy for Eagle's Syndrome. Indian J Otolaryngol Head Neck Surg. 2013;65(1):20–3.
7. Kosar MI, Atalar MH, Sabancioğullari V, Tetiker H, Erdil FH, Cimen M, Otağ I. Evaluation of the length and angulation of the styloid process in the patient with pre-diagnosis of Eagle syndrome. Folia Morphol (Warsz) 2011;70(4):295–9.
8. Cullu N, Deveer M, Sahan M, Tetiker H, Yilmaz M. Radiological evaluation of the styloid process length in the normal population. Folia Morphol (Warsz) 2013;72(4):318–21.
9. Vadgaonkar R, Murlimanju BV, Prabhu LV, Rai R, Pai MM, Tonse M, Jiji PJ. Morphological study of styloid process of the temporal bone and its clinical implications. Anat Cell Biol. 2015;48(3):195–200.
10. Roopashri G, Vaishali MR, David MP, Baig M. Evaluation of elongated styloid process on digital panoramic radiographs. J Contemp Dent Pract. 2012;13(5):618–22.
11. Patil S, Ghosh S, Vasudeva N. Morphometric study of the styloid process of temporal bone. J Clin Diagn Res. 2014;8(9):AC04–6.
12. Zeckler SR, Betancur AG, Yaniv G. The eagle is landing: Eagle syndrome--an important differential diagnosis. Br J Gen Pract. 2012;62(602):501–2.
13. Gupta N. Diagnosis and management of Eagle’s syndrome: a clinical review. Asian J Mod Ayurvedic Med Sci. 2012;1(1):1–7.
14. Romero JG, Nieto MAM, Sánchez AAR. Eagle’s syndrome. Patient handling at the «Licenciado Adolfo López Mateos» Hospital Mexico City. Rev Odont Mex. 19(4):e254–8.
15. Phulambrikar T, Rajeshwari A, Rao BB, Warhekar AM, Reddy P. Incidence of elongated styloid process: a radiographic study. J Indian Acad Oral Med Radiol. 2011;23(3):S344–6.
16. Colby CC, Del Gaudio JM. Stylohyoid complex syndrome: a new diagnostic classification. Arch Otolaryngol Head Neck Surg. 2011;137(3):248–52.
17. Santini L, Achache M, Gomert R, Mardassi A, Lafont B, Magnan J, Lavieille JP, Devèze A. Transoral surgical treatment of Eagle's syndrome: case report and review of literature. Rev Laryngol Otol Rhinol (Bord) 2012;133(3):141–4.
18. Öztaş B, Orhan K. Investigation of the incidence of stylohyoid ligament calcifications with panoramic radiographs. J Investig Clin Dent. 2012;3(1):30–5.
19. Fusco DJ, Asteraki S, Spetzler RF. Eagle's syndrome: embryology, anatomy, and clinical management. Acta Neurochir (Wien) 2012;154(7):1119–26.
20. Andrei F, Motoc AG, Didilescu AC, Rusu MC. A 3D cone beam computed tomography study of the styloid process of the temporal bone. Folia Morphol (Warsz) 2013;72(1):29–35.
21. Spalthoff S, Zimmerer R, Dittmann O, Tavassol F, Dittmann J, Gellrich NC, Jehn P. Piezoelectric surgery and navigation: a safe approach for complex cases of Eagle syndrome. Int J Oral Maxillofac Surg. 2016;pii: S0901-5027(16):30068–6.
22. Kim SM, Seo MH, Myoung H, Choi JY, Kim YS, Lee SK. Osteogenetic changes in elongated styloid processes of Eagle syndrome patients. J Craniomaxillofac Surg. 2014;42(5):661–7.
23. Shaik MA, Naheeda , Kaleem SM, Wahab A, Hameed S. Prevalence of elongated styloid process in Saudi population of Aseer region. Eur J Dent. 2013;7(4):449–54.
24. Sudhakara Reddy R, Sai Kiran Ch, 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(1):e30–5.
25. Hoffmann E, Räder C, Fuhrmann H, Maurer P. Styloid-carotid artery syndrome treated surgically with Piezosurgery: a case report and literature review. J Craniomaxillofac Surg. 2013;41(2):162–6.
26. Yavuz H, Caylakli F, Erkan AN, Ozluoglu LN . Modified intraoral approach for removal of an elongated styloid process. J Otolaryngol Head Neck Surg. 2011;40(1):86–90.
27. Scheller K, Eckert AW, Scheller C. Transoral, retromolar, para-tonsillar approach to the styloid process in 6 patients with Eagle's syndrome. Med Oral Patol Oral Cir Bucal. 2014;19(1):e61–6.
28. Dou G, Zhang Y, Zong C, Chen Y, Guo Y, Tian L. Application of surgical navigation in styloidectomy for treating Eagle's syndrome. Ther Clin Risk Manag. 2016;12:575–83.
29. Yasmeenahamed S, Laliytha BK, Sivaraman S, Ambiga P, Dineshshankar J, Sudhaa M. Eagle's syndrome - Masquerading as ear pain: Review of literature. J Pharm Bioallied Sci. 2015;7(Suppl 2):S372–3.
30. Migliario M, Lucchina AG, Francone S, Renò F, Mortellaro C. Elongated styloid process (Eagle’s Syndrome) causing orofacial pain. Int J Clin Dent. 2011;4(4):375–81.
31. Al Weteid AS, Miloro M. Transoral endoscopic-assisted styloidectomy: How should Eagle syndrome be managed surgically? Int J Oral Maxillofac Surg. 2015;44(9):1181–7.
32. Permpalung N, Suksaranjit P, Chongnarungsin D, Hyman CL. Unveiling the hidden eagle: acute parotitis-induced eagle syndrome. N Am J Med Sci. 2014;6(2):102–4.
33. Bagga MB, Kumar CA, Yeluri G. Clinicoradiologic evaluation of styloid process calcification. Imaging Sci Dent. 2012;42(3):155–61.
34. Anbiaee N, Javadzadeh A. Elongated styloid process: is it a pathologic condition? Indian J Dent Res. 2011;22(5):673–7.
35. Keur JJ, Campbell JP, McCarthy JF, Ralph WJ. The clinical significance of the elongated styloid process. Oral Surg Oral Med Oral Pathol. 1986;61(4):399–404.
36. Abdel-Ghany AF, Osman NM. Role of three-dimensional multidetector computerized tomography in diagnosis of Eagle's syndrome. Egypt J Radiol Nucl Med. 2014;45:105–8.
37. Vieira EM, Guedes OA, Morais SD, Musis CR, Albuquerque PA, Borges ÁH. Prevalence of Elongated Styloid Process in a Central Brazilian Population. J Clin Diagn Res. 2015;9(9):ZC90–2.
38. Kaufman SM, Elzay RP, Irish EF. Styloid process variation. Radiologic and clinical study. Arch Otolaryngol. 1970;91(5):460–3.
39. Lindeman P. The elongated styloid process as a cause of throat discomfort. Four case reports. J Laryngol Otol. 1985;99(5):505–8.
40. Langlais RP, Miles DA, Van Dis ML. Elongated and mineralized stylohyoid ligament complex: a proposed classification and report of a case of Eagle's syndrome. Oral Surg Oral Med Oral Pathol. 1986;61(5):527–32.
41. de Andrade KM, Rodrigues CA, Watanabe PC, Mazzetto MO. Styloid process elongation and calcification in subjects with tmd: clinical and radiographic aspects. Braz Dent J. 2012;23(4):443–50.
42. Sharma V, Bajwa SJ. The potential role of dexmeditomidine during perioperative period in a hypertensive patient with Eagle syndrome. Anesth Essays Res. 2013;7(3):423–4.
43. Morrison PJ, Morrison RJ, McKinstry CS. Familial ossification of the stylohyoid ligament in a three generation family--a new clinical entity displaying autosomal dominant inheritance. Br J Radiol. 2012;85(1012):458–9.
44. Todo T, Alexander M, Stokol C, Lyden P, Braunstein G, Gewertz B. Eagle syndrome revisited: cerebrovascular complications. Ann Vasc Surg. 2012;26(5):729–e1-5.
Published
2016-09-14
How to Cite
ARBILDO, Heber Isac et al.
Eagle syndrome. A narrative review..
Journal of Oral Research, [S.l.], v. 5, n. 6, p. 248-254, sep. 2016.
ISSN 0719-2479.
Available at: <https://joralres.com/index.php/JOralRes/article/view/joralres.2016.054>. Date accessed: 30 apr. 2024.
doi: https://doi.org/10.17126/joralres.2016.054.
Issue
Section
Reviews
Keywords
Eagle syndrome; styloid process; stylohyoid ligament; facial pain; review.
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