Elongation or Angulation of Styloid Process: Discussion with a Case Report and Review of the Literature

Elif Şener; Ceyda Gürhan; Naim Ceylan; Pelin Güneri

doi:10.7126/cumudj.435368

Case Report

Elongation or Angulation of Styloid Process: Discussion with a Case Report and Review of the Literature

Year 2018, Volume: 21 Issue: 4, 396 - 403, 30.12.2018

Elif Şener , Ceyda Gürhan , Naim Ceylan Pelin Güneri

https://doi.org/10.7126/cumudj.435368

Cited By: 1

Abstract

Styloid process of temporal bone is a pointed projection from the petrous part of temporal bone which ranges with an average of 25 mm in length, and any process longer than 30 mm is defined as the "Elongated Styloid Process”. In asymptomatic cases, diagnosis is usually made with routine radiological examination, but morphological aspects of styloid process can be evaluated with different imaging modalities. Although digital panoramic radiographs are sufficiently accurate for the diagnosis of elongated styloid process, multislice computed tomography scan with 3D reconstruction can further assist in determining the actual length and correct relationship with the surrounding adjacent anatomical structures. The aim of this case report is to investigate the morphological characteristics of an unilateral elongated styloid process (ESP) using both conventional and multidetector computed tomography (MDCT) on a 55 year old asymptomatic male patient and to review the literature.

Keywords

elongated styloid process, multipledetector computed tomography, structural deviation

References

1. Başekim CC et al. Evaluation Of Styloid Process By Three-Dimensional Computed Tomography. Eur Radiol. 2005;15(1):134-139
2. 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. 2014 ;36(1):39-46.
3. 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(12):1446-1452.
4. Kumar M, Sankaran P, Yuvaraj M, Gunaprıya R, Begum Z. Morphologıcal Study Of Styloid Process And Its Variations In Human Skull. Int J Pharm Bio Sci 2017; 8(3): 87 - 90.
5. Onbas O et al. Angulation, Length, And Morphology Of The Styloid Process Of The Temporal Bone Analyzed By Multidetector Computed Tomography. Acta Radiologica. 2005;46(8):881-886.
6. Ramadan SU, Gokharman D, Tunçbilek I, Kacar M, Koşar P, Kosar U. Assessment Of The Stylohoid Chain By 3D-CT. Surg Radiol Anat. 2007;29(7):583-588.
7. Buyuk C, Gunduz K, Avsever H. Morphological Assessment Of The Stylohyoid Complex Variations With Cone Beam Computed Tomography In A Turkish Population. Folia Morphol., 2018;77(1): 79–89.
8. Gözil R, Yener N, Calgüner E, Araç M, Tunç E, Bahcelioğlu M. Morphological Characteristics Of Styloid Process Evaluated By Computerized Axial Tomography. Ann Anat. 2001;183(6):527-535.
9. Hardy H, Guichard B, Eliezer M, Choussy O, Péron JM, Trost O. Unilateral Complete Articulated Ossification Of The Stylohyoid Apparatus: Case Report And Review Of The Literature. Surg Radiol Anat. 2014;36(9):941-5.
10. 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):527-532.
11. Viéla A. Contribution À L’étude Des Anomalies De L’appareil Hyoïdien. Bulletins et Mémoires de la Société d’anthropologie de Paris VIIe série 1925;6(1–3):89–97.
12. MacDonald-Jankowski DS.Calcification Of The Stylohyoid Complex In Londoners And Hong Kong Chinese. Dentomaxillofac Radiol. 2001;30(1):35-9.
13. Kursoglu P, Unalan F, Erdem T. Radiological Evaluation Of The Styloid Process In Young Adults Resident In Turkey’s Yeditepe University Faculty Of Dentistry. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005; 100(4): 491–94.
14. Okabe S, Morimoto Y, Ansai T, Yamada K, Tanaka T, Awano S et al. Clinical Significance And Variation Of The Advanced Calcified Stylohyoid Complex Detected By Panoramic Radiographs Among 80-Year-Old Subjects. Dentomaxillofac Radiol 2006;35:191–99.
15. Sveinsson O, Kostulas N, Herrman L. Internal Carotid Dissection Caused By An Elongated Styloid Process (Eagle Syndrome). BMJ Case Rep. 2013.
16. Okur A, Ozkırış M, Serin HI, Gencer ZK, Karaçavuş S, Karaca L. Is There A Relationship Between Symptoms Of Patients And Tomographic Characteristics Of Styloid Process. Surg Radiol Anat. 2014 ;36(7):627-632.
17. Lins CC, Tavares RM, da Silva CC. Use Of Digital Panoramic Radiographs In The Study Of Styloid Process Elongation. Anat Res Int. 2015;2015:474615.
18. Sharma N, Ram R, Kamal R. Unusually Elongated Styloid Process: A Report Of Two Cases With Literature Review. Ann Maxillofac Surg. 2016;6(2):297-299.
19. Pereira FL, Filho LI, Pavan AJ, Farah GJ, Goncalves EA, Veltrini VC et al. Styloid-Stylohyoid Syndrome: Literature Review And Case Report. J Oral Maxillofac Surg 2007;65:1346–1353.
20. Valerio CS, Peyneau PD, de Sousa AC, Cardoso FO, de Oliveira DR, Taitson PF et al. Stylohyoid Syndrome: Surgical Approach. J Craniofac Surg. 2012;23:138–140.
21. Yavuz H, Caylakli F, Yildirim T, Ozluoglu LN. Angulation Of The Styloid Process In Eagle’s Syndrome. Eur Arch Otorhinolaryngol. 2008;265:1393–1396.
22. Kamal A, Nazir R, Usman M, Salam BU, Sana F. Eagle Syndrome; Radiological Evaluation And Management. J Pak Med Assoc. 2014;64(11):1315-1317.
23. Karam C, Koussa S. Eagle Syndrome: The Role Of CT Scan With 3D Reconstructions. J Neuroradiol. 2007;34(5):344-345.
24. Eagle WW. The Symptoms, Diagnosis And Treatment Of The Elongated Styloid Process. Am Surg. 1962;28:1-5.
25. Skrzat J, Mroz I, Walocha J, Zawilinski J, Jaworek JK. Bilateral Ossification Of The Stylohyoid Ligament. Folia Morphol. 2007, 66. (3), 203-206.
26. Moffat DA, Ramsden RT, Shaw HJ. The Styloid Process Syndrome: Aetiological Factors And Surgical Management. J Laryngol Otol. 1977;91(4):279-294.
27. Nakamaru Y, Fukuda S, Miyashita S, Ohashi M. Diagnosis Of The Elongated Styloid Process By Three-Dimensional Computed Tomography. Auris Nasus Larynx. 2002;29(1):55-57.
28. Kent DT, Rath TJ, Snyderman C. Conventional And 3-Dimensional Computerized Tomography In Eagle's Syndrome, Glossopharyngeal Neuralgia, And Asymptomatic Controls. Otolaryngol Head Neck Surg. 2015;153(1):41-47.
29. Pokharel M, Karki S, Shrestha I, Shrestha BL, Khanal K, Amatya RC. Clinicoradiologic Evaluation Of Eagle's Syndrome And Its Management. Kathmandu Univ Med J. 2013;11(44):305-309.
30. Burulday V, Akgül MH, Bayar Muluk N, Yağdiran B, Inal M. The Importance Of Medial-Lateral Styloid Process Angulation/Coronal Plane Angle In Symptomatic Eagle Syndrome. Clin Anat. 2017;30(4):487-491.
31. Sokler K, Sandev S. New Classification Of The Styloid Process Length--Clinical Application On The Biological Base. Coll Antropol. 2001;25(2):627-632.

Year 2018, Volume: 21 Issue: 4, 396 - 403, 30.12.2018

Elif Şener , Ceyda Gürhan , Naim Ceylan Pelin Güneri

https://doi.org/10.7126/cumudj.435368

Cited By: 1

Abstract

References

1. Başekim CC et al. Evaluation Of Styloid Process By Three-Dimensional Computed Tomography. Eur Radiol. 2005;15(1):134-139
2. 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. 2014 ;36(1):39-46.
3. 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(12):1446-1452.
4. Kumar M, Sankaran P, Yuvaraj M, Gunaprıya R, Begum Z. Morphologıcal Study Of Styloid Process And Its Variations In Human Skull. Int J Pharm Bio Sci 2017; 8(3): 87 - 90.
5. Onbas O et al. Angulation, Length, And Morphology Of The Styloid Process Of The Temporal Bone Analyzed By Multidetector Computed Tomography. Acta Radiologica. 2005;46(8):881-886.
6. Ramadan SU, Gokharman D, Tunçbilek I, Kacar M, Koşar P, Kosar U. Assessment Of The Stylohoid Chain By 3D-CT. Surg Radiol Anat. 2007;29(7):583-588.
7. Buyuk C, Gunduz K, Avsever H. Morphological Assessment Of The Stylohyoid Complex Variations With Cone Beam Computed Tomography In A Turkish Population. Folia Morphol., 2018;77(1): 79–89.
8. Gözil R, Yener N, Calgüner E, Araç M, Tunç E, Bahcelioğlu M. Morphological Characteristics Of Styloid Process Evaluated By Computerized Axial Tomography. Ann Anat. 2001;183(6):527-535.
9. Hardy H, Guichard B, Eliezer M, Choussy O, Péron JM, Trost O. Unilateral Complete Articulated Ossification Of The Stylohyoid Apparatus: Case Report And Review Of The Literature. Surg Radiol Anat. 2014;36(9):941-5.
10. 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):527-532.
11. Viéla A. Contribution À L’étude Des Anomalies De L’appareil Hyoïdien. Bulletins et Mémoires de la Société d’anthropologie de Paris VIIe série 1925;6(1–3):89–97.
12. MacDonald-Jankowski DS.Calcification Of The Stylohyoid Complex In Londoners And Hong Kong Chinese. Dentomaxillofac Radiol. 2001;30(1):35-9.
13. Kursoglu P, Unalan F, Erdem T. Radiological Evaluation Of The Styloid Process In Young Adults Resident In Turkey’s Yeditepe University Faculty Of Dentistry. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005; 100(4): 491–94.
14. Okabe S, Morimoto Y, Ansai T, Yamada K, Tanaka T, Awano S et al. Clinical Significance And Variation Of The Advanced Calcified Stylohyoid Complex Detected By Panoramic Radiographs Among 80-Year-Old Subjects. Dentomaxillofac Radiol 2006;35:191–99.
15. Sveinsson O, Kostulas N, Herrman L. Internal Carotid Dissection Caused By An Elongated Styloid Process (Eagle Syndrome). BMJ Case Rep. 2013.
16. Okur A, Ozkırış M, Serin HI, Gencer ZK, Karaçavuş S, Karaca L. Is There A Relationship Between Symptoms Of Patients And Tomographic Characteristics Of Styloid Process. Surg Radiol Anat. 2014 ;36(7):627-632.
17. Lins CC, Tavares RM, da Silva CC. Use Of Digital Panoramic Radiographs In The Study Of Styloid Process Elongation. Anat Res Int. 2015;2015:474615.
18. Sharma N, Ram R, Kamal R. Unusually Elongated Styloid Process: A Report Of Two Cases With Literature Review. Ann Maxillofac Surg. 2016;6(2):297-299.
19. Pereira FL, Filho LI, Pavan AJ, Farah GJ, Goncalves EA, Veltrini VC et al. Styloid-Stylohyoid Syndrome: Literature Review And Case Report. J Oral Maxillofac Surg 2007;65:1346–1353.
20. Valerio CS, Peyneau PD, de Sousa AC, Cardoso FO, de Oliveira DR, Taitson PF et al. Stylohyoid Syndrome: Surgical Approach. J Craniofac Surg. 2012;23:138–140.
21. Yavuz H, Caylakli F, Yildirim T, Ozluoglu LN. Angulation Of The Styloid Process In Eagle’s Syndrome. Eur Arch Otorhinolaryngol. 2008;265:1393–1396.
22. Kamal A, Nazir R, Usman M, Salam BU, Sana F. Eagle Syndrome; Radiological Evaluation And Management. J Pak Med Assoc. 2014;64(11):1315-1317.
23. Karam C, Koussa S. Eagle Syndrome: The Role Of CT Scan With 3D Reconstructions. J Neuroradiol. 2007;34(5):344-345.
24. Eagle WW. The Symptoms, Diagnosis And Treatment Of The Elongated Styloid Process. Am Surg. 1962;28:1-5.
25. Skrzat J, Mroz I, Walocha J, Zawilinski J, Jaworek JK. Bilateral Ossification Of The Stylohyoid Ligament. Folia Morphol. 2007, 66. (3), 203-206.
26. Moffat DA, Ramsden RT, Shaw HJ. The Styloid Process Syndrome: Aetiological Factors And Surgical Management. J Laryngol Otol. 1977;91(4):279-294.
27. Nakamaru Y, Fukuda S, Miyashita S, Ohashi M. Diagnosis Of The Elongated Styloid Process By Three-Dimensional Computed Tomography. Auris Nasus Larynx. 2002;29(1):55-57.
28. Kent DT, Rath TJ, Snyderman C. Conventional And 3-Dimensional Computerized Tomography In Eagle's Syndrome, Glossopharyngeal Neuralgia, And Asymptomatic Controls. Otolaryngol Head Neck Surg. 2015;153(1):41-47.
29. Pokharel M, Karki S, Shrestha I, Shrestha BL, Khanal K, Amatya RC. Clinicoradiologic Evaluation Of Eagle's Syndrome And Its Management. Kathmandu Univ Med J. 2013;11(44):305-309.
30. Burulday V, Akgül MH, Bayar Muluk N, Yağdiran B, Inal M. The Importance Of Medial-Lateral Styloid Process Angulation/Coronal Plane Angle In Symptomatic Eagle Syndrome. Clin Anat. 2017;30(4):487-491.
31. Sokler K, Sandev S. New Classification Of The Styloid Process Length--Clinical Application On The Biological Base. Coll Antropol. 2001;25(2):627-632.

There are 31 citations in total.

Details

Primary Language	English
Subjects	Health Care Administration
Journal Section	Case Reports
Authors	Elif Şener Ceyda Gürhan Naim Ceylan Pelin Güneri
Publication Date	December 30, 2018
Submission Date	June 21, 2018
Published in Issue	Year 2018Volume: 21 Issue: 4

Cite

EndNote	Şener E, Gürhan C, Ceylan N, Güneri P (December 1, 2018) Elongation or Angulation of Styloid Process: Discussion with a Case Report and Review of the Literature. Cumhuriyet Dental Journal 21 4 396–403.

Cited By

An unusual case of excessive angulation of styloid process and ossified stylohyoid complex causing Eagle’s syndrome: a case report

The Egyptian Journal of Otolaryngology

https://doi.org/10.1186/s43163-023-00538-5

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Cumhuriyet Dental Journal (Cumhuriyet Dent J, CDJ) is the official publication of Cumhuriyet University Faculty of Dentistry. CDJ is an international journal dedicated to the latest advancement of dentistry. The aim of this journal is to provide a platform for scientists and academicians all over the world to promote, share, and discuss various new issues and developments in different areas of dentistry. First issue of the Journal of Cumhuriyet University Faculty of Dentistry was published in 1998. In 2010, journal's name was changed as Cumhuriyet Dental Journal. Journal’s publication language is English.

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