Signs and symptoms of Eagle syndrome:
- Sharp, shooting pain in the jaw, back of the throat, base of the tongue, ears, neck, and/or face
- Difficulty swallowing
- Sensation of having a foreign object in throat
- Pain from chewing, swallowing, turning the neck, or touching the back of the throat
- Ringing or buzzing in the ears
Causes and diagnosis of Eagle syndrome:
- Eagle syndrome occurs due to elongation of the styloid process or calcification of the stylohyoid ligament
- Elongation of the styloid process can occur spontaneously or since birth
- Reports of Eagle syndrome being elicited after wisdom tooth removal
- Diagnosis is suspected when a patient presents with symptoms such as unilateral neck pain, sore throat, or tinnitus
- Palpation of the tip of the styloid process in the back of the throat may be possible
- Bimanual palpation of the styloid through the tonsillar bed can worsen symptoms
- Lidocaine infiltration into the tonsillar bed may relieve symptoms
- Imaging techniques such as CT scan with 3D reconstruction are important for diagnosis
Treatment options for Eagle syndrome:
- Surgical treatment is preferred for both classic and vascular forms of Eagle syndrome
- Partial styloidectomy is the preferred surgical approach
- Repair of a damaged carotid artery is essential to prevent further complications
- Medical management may include pain and anti-inflammatory medications, antidepressants, and corticosteroids
- Overall success rate for treatment (medical or surgical) is about 80%
Epidemiology of Eagle syndrome:
- Approximately 4% of the general population have an elongated styloid process, and about 4% of them experience symptoms of Eagle syndrome
- Incidence of stylohyoid syndrome may be about 0.16%
- More recent studies report the incidence of styloid elongation to be as high as 54%
- Patients with Eagle syndrome are typically between 30 and 50 years of age, but it can occur in teenagers and older patients
- It is more common in women, with a male to female ratio of approximately 1:2
Eagle syndrome (also termed stylohyoid syndrome, styloid syndrome, styloid-stylohyoid syndrome, or styloid–carotid artery syndrome) is an uncommon condition commonly characterized but not limited to sudden, sharp nerve-like pain in the jaw bone and joint, back of the throat, and base of the tongue, triggered by swallowing, moving the jaw, or turning the neck. First described by American otorhinolaryngologist Watt Weems Eagle in 1937, the condition is caused by an elongated or misshapen styloid process (the slender, pointed piece of bone just below the ear) and/or calcification of the stylohyoid ligament, either of which interferes with the functioning of neighboring regions in the body, such as the glossopharyngeal nerve.
Eagle syndrome | |
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Other names | Styloid syndrome |
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Anteroposterior and lateral radiographs of cervical spine showing ossification of the stylohyoid ligament on both sides |