Eagle syndrome in dental practice: a clinical case

OBJECTIVES: The styloid process is a cylindrical and sharp projection of the temporal bone, with an average normal length of 20-30 mm. When the styloid process appeared longer than 30 mm, it is called elongated styloid process. The increasement of the length of the styloid process may be associated with the calcification of the stylohyoid ligament. The clinical condition in which the elongation of the styloid process and/ or the calcification of the stylohyoid ligament is associated with symptoms is defined as Eagle syndrome.
This case report aims to present the clinical case of a young 27-year-old Italian patient diagnosed with Eagle syndrome, subsequently treated with surgical therapy.

MATERIALS AND METHODS: The case of a young 27-year-old Italian woman with cervicofacial pain and dysphagia has been described. These symptoms were initially considered associated with third molar dysodontiasis; however, their extraction did not lead to the resolution of the reported symptoms. Panoramic radiography of the dental arches and cone beam computed tomography (CBCT) showed the presence of a bilateral calcification of the stylohyoid ligament, leading to the diagnosis of bilateral lengthening of the styloid process. Since this elongated styloid process was associated to symptoms, the final diagnosis was Eagle syndrome. The patient was surgically treated by bilateral transcervical exeresis of the styloid process.

RESULTS: Surgery led to complete resolution of the patient’s symptoms. At the 6 and 12 months after surgery follow-up, the residual surgical scar can be considered aesthetically acceptable.

CONCLUSIONS: The symptomatic elongation of the styloid process may be a cause of cervicofacial pain; therefore, it should be considered as a diagnostic hypothesis during the differential diagnosis of a patient reporting this type of symptomatology. The scrupulous observation of the radiographic images, in association with the symptoms reported by the patient, allows to formulate the definitive diagnosis of Eagle syndrome.

CLINICAL SIGNIFICANCE: The clinical significance of this case report is to focus the attention on the possible role of the dentist in the diagnosis of an unknow Eagle syndrome to a patient with symptoms in the cervicofacial district.

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