Eagle Syndrome A Comprehensive Review of Pathophysiology, Diagnosis and Management Strategies
DOI:
https://doi.org/10.12775/QS.2025.47.66729Keywords
Eagle's syndrome, glossopharyngeal neuralgia, elongated styloid process, styloidectomy, 3D-CT/CBCT, surgical treatmentAbstract
Eagle syndrome, also known as elongated styloid process syndrome, is a rare condition resulting from excessive elongation of the styloid process or calcification of the stylohyoid ligament. These abnormalities may compress adjacent neural and vascular structures, producing a wide range of symptoms such as throat, ear or facial pain, dysphagia, or the sensation of a foreign body in the throat. Due to the proximity of critical anatomic structures and the nonspecific clinical presentation, Eagle syndrome poses a significant diagnostic challenge and should be considered in the evaluation of craniofacial and cervical pain.
References
1. Paraskevas GK, Poutoglidis A, Lazaridis N, Asouhidou E, Chrysanthou C, Apostolidi E, Ili-ou K, Tsetsos N, Forozidou E, Karamitsou P, Skalias A, Vlactshis K: Does the orientation of the styloid process cause Eagle Syndrome? An anatomical study of the styloid process in 72 Greek skulls; Otolaryngol Pol 2022; 76 (4): 1–6. DOI: 10.5604/01.3001.0015.8627
2. Wang J, Liu Y, Wang ZB, Yan KS: Intraoral and extraoral approach for surgical treatment of Eagle’s syndrome: a retrospective study. Eur Arch Otorhinolaryngol., 2022; 279(3): 1481–1487. DOI: 10.1007/s00405-021-06914-2
3. De Ravin E, Frost AS, Mady LJ, Newman JG: Transcervical styloidectomy for Eagle syndrome. Head Neck., 2022 Feb 21. DOI: 10.1002/hed.27013
4. Egierska D, Perszke M, Kurianowicz I: Eagle’s syndrome. Pol Merkur Lekarski, 2021; 49(294): 458–460.
5. Moon CS, Lee BS, Kwon YD, Choi BJ, Lee JW, Lee HW, Yun SU, Ohe JY. Eagle’s syndrome: a case report. J Korean Assoc Oral Maxillofac Surg. 2014;40(1):43–7. DOI: 10.5125/jkaoms.2014.40.1.43
6. Bhosle R, Aditya G, Das S, Krishnan P: Eagle’s Syndrome. Department of Neurosurgery & Radiology, Calcutta, 2022 Jan-Feb;70(1):180-181. DOI: 10.4103/0028-3886.338720
7. Bochenek A, Reicher M: Human Anatomy. Tom I. PZWL, Warszawa 2012.
8. Miłoński J, Olszewski J: Chronic unilateral neck pain when moving the head and swallowing. Med Dypl, 2017; 6; 24–31.
9. Triantafyllou G, Paschopoulos I, Duparc F, Tsakotos G, Papadopoulos-Manolarakis P, Piagkou M: The Anatomy of the Stylohyoid Chain: A Systematic Review with Meta-Analysis. DOI: 10.3390/diagnostics15070925
10. Fusco DJ, Asteraki S, Spetzler RF. Eagle’s syndrome: embryology, anatomy, and clinical management. Acta Neurochir (Wien) 2012; 154(07):1119–1126. DOI: 10.1007/s00701-012-1385-2
11. Okur A, Ozkırış M, Serin HI, et al. Is there a relationship between symptoms of patients and tomographic characteristics of styloid process, Surg Radiol Anat 2014;36(07):627–632. DOI: 10.1007/s00276-013-1213-2
12. González García N, García Azorín D, Porta Etessam J. Eagle syndrome: Toward a clinical delimitation. Neurologia 2021;36:412 7. DOI: 10.1016/j.nrleng.2018.03.007
13. Eagle WW. Elongated styloid process; symptoms and treatment. AMA Arch Otolaryngol. 1958;67(2):172–6. 18. DOI: 10.1001/archotol.1958.00730010178007
14. Bafaqeeh SA: Eagle Syndrome: Classic and carotid artery types. J Otolaryngol, 2000; 29(2): 88–94.
15. Ferrario VF, Sigurta D, Daddona A, Dalloca L, Miani A, et al.: Calcification of the stylohyoid ligament. Oral Surg Oral Med Oral Pathol, 1990; 69: 524–529. DOI: 10.1016/0030-4220(90)90390-e
16. Kaufman SM, Elzay RP, Irish EF: Styloid process variation. Arch Otolaryngol, 1970; 91: 460–463. DOI: 10.1001/archotol.1970.00770040654013
17. Wacławek MS, Pietkiewicz P, Niewiadomski P, Olszewski J: Own experience in the diagnosis and treatment of elongated styloid process syndrome. Otolaryngol Pol 2020; 74 (1–7). DOI: 10.5604/01.3001.0014.3666
18. Eagle W. Elongated styloid process: report of two cases. Arch Otolaryngol 1937; 25: 584–586. DOI: 10.1001/archotol.1937.00650010656008
19. Kawasaki M, Hatashima S, Matsuda T: Non-surgical therapy for bilateral glossopharyngeal neuralgia caused by Eagle’s syndrome… J Anesth 2012; 26(6): 918–921. DOI: 10.1007/s00540-012-1437-z
20. Saccomanno S, Greco F, De Corso E, et al.: Eagle’s Syndrome, from clinical presentation to diagnosis and surgical treatment: a case report. Acta Otorhinolaryngol Ital 2018; 38(2):166–169. DOI: 10.14639/0392-100X-1479
21. Tanaka S, Terayama H, Miyaki Y, et al.: A gross anatomical study of the styloid process of the temporal bone in Japanese cadavers. Folia Morphol, 2022; 81(2): 493–502. DOI: 10.5603/FM.a2021.0019
22. Swapna LA, AlMegbil NT, Almutlaq AO, Koppolu P: Occurrence of the Elongated Styloid Process on Digital Panoramic Radiographs in the Riyadh Population. Radiol Res Pract., 2021; 2021: 6097795. DOI: 10.1155/2021/6097795
23. Balcioglu HA, Kilic C, Akyol M, et al.: Length of the styloid process and anatomical implications for Eagle’s syndrome. Folia Morphol, 2009; 68(4): 265–270.
24. Bożyk A, Krawczyk J, Wiktor-Stoma A, Mieszkowski P, Borowicz J, et al.: Assessment of the size of the styloid process based on CBCT examinations, EJMT, 2014; 1(2): 29–37. DOI: 10.1186/1746-160X-10-5
25. Eagle WW: Elongated styloid process, further observations and a new syndrome. Arch Otolaryngol, 1948; 47: 630–640. DOI: 10.1001/archotol.1948.00690030654006
26. Bafaqeeh SA: Eagle Syndrome: Classic and carotid artery types. J Otolaryngol, 2000; 29(2): 88–94.
27. Mishra A, Dabholkar J, Lodha J, Sharma A: Stylalgia: A Missed Diagnosis. Otolaryngol Pol, 2015; 69(2): 34–37. DOI: 10.5604/00306657.1131148
28. Iwańczyk B, Szerszeń M, Nowak J, Chmura A, Wojtowicz A: Eagle syndrome – a review of the literature, Nowa Stomatologia, 2015; 20(4): 167–172. DOI:10.5604/14266911.1188973
29. Langlais RP, Miles DA, Van Dis ML: Elongated and mineralized stylohyoid ligament complex: a proposed classification and report of a case Eagle’s syndrome, Oral Surg Oral Med Oral Pathol, 1986; 61: 527–532. DOI: 10.1016/0030-4220(86)90400-7
30. O’Carroll MK: Calcification in the stylohyoid ligament. Oral Surg Oral Med Oral Pathol, 1984; 58: 617–621. DOI: 10.1016/0030-4220(84)90089-6
31. Maradesha PS, et al. Styloidectomy: our experience with intraoral approach. Int J Otorhinolaryngol Head Neck Surg 2020; 6(11):2106–2109. DOI:10.18203/issn.2454-5929.ijohns20204639
32. Badhey A, et al.: Eagle syndrome: a comprehensive review. Clin Neurol Neurosurg 159:34–38 (2017). DOI: 10.1016/j.clineuro.2017.04.021
33. Elimairi I, Baur DA, Altay MA, Quereshy FA, Minisandram A: Eagle’s Syndrome. Head and Neck Pathol (2015) 9:492–495. DOI: 10.1007/s12105-014-0599-4
34. Dziedzic M, Sokołowski G, Hubalewska-Dydejczyk A, Trofimiuk-Müldner M: Eagle’s syndrome mimicking thyroid-associated orbitopathy. Endokrynologia Polska, 2023. DOI: 10.5603/ep.96351
35. Li M., Sun Y, Chan C, et al.: Internal jugular vein stenosis associated with elongated styloid process. BMC Neurology. 2019; 19(1): 112. DOI: 10.1186/s12883-019-1344-0
36. 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: 443–450. DOI: 10.1590/s0103-64402012000400023
37. Wong ML, Rossi MD, Groff W, Castro S, Powell J: Physical therapy management of a patient with Eagle syndrome. Physiother Theory Pract 27(4):319–327 (2011). DOI: 10.3109/09593985.2010.498036
38. Müderris T, Bercin S, Sevil E, Beton S, Kiris M: Surgical management of elongated styloid process: intraoral or transcervical? Eur Arch Otorhinolaryngol 2014;271(6):1709–13. DOI: 10.1007/s00405-013-2664-0
39. Kumai Y, Hamasaki T, Yumoto E: Surgical management of Eagle’s syndrome… Eur Arch Otorhinolaryngol, 2016; 273(10): 3421–3427.4. DOI: 10.1007/s00405-016-4057-7
40. Buono U, Mangone GM, Michelotti A, Longo F, Califano L: Surgical Approach to the Stylohyoid Process in Eagle’s Syndrome. J Oral Maxillofac Surg, 2005; 63: 714–716. DOI: 10.1016/j.joms.2004.10.013
41. Pigache P, Fontaine C, Ferri J, Raoul G: Transcervical styloidectomy in Eagle's syndrome. Eur Ann Otorhinolaryngol Head Neck Dis. 2018;135(6):433-436. DOI: 10.1016/j.anorl.2018.05.001
42. Saumya T, Sharad Ch, Shishir D: Stylalgia and Styloidectomy: A Review, J. Maxillofac. Oral Surg. 2023; 22(1):60–66. DOI: 10.1007/s12663-022-01720-7
43. Mendelsohn AH, Berke GS, Chhetri DK (2006): Heterogeneity in the clinical presentation of Eagle’s syndrome. Otolaryngol Head Neck Surg 134:389–393. DOI: 10.1016/j.otohns.2005.10.046
44. Yavuz H, Caylakli F, Yildirim T, Ozluoglu LN (2008): Angulation of the styloid process in Eagle’s syndrome. Eur Arch Otorhinolaryngol 265:1393–1396. DOI: 10.1007/s00405-008-0686-9
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Copyright (c) 2025 Szymon Górski, Joanna Okupniarek, Michalina Bartosik, Igor Jętasiewicz, Michał Oborski, Krzysztof Oborski, Jakub Miarczyński

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