舌骨に癒合した巨大な茎状突起過長症例

抄録

In this report, we present an overview of cases with an elongated styloid process with a large diameter of 65 mm that was attached to the hyoid bone. Treatment for this condition could be conservative or surgical. Conservative treatment includes medications such as anti-inflammatory analgesics, physical therapy, such as nerve block, and infrared irradiation. In the case of a hyperplastic stalk process that adheres to the hyoid bone, as in this case, it is considered that total excision by external incision is a valid treatment option.

We encountered a patient with a hypertrophic styloid process that measured 65 mm in diameter and was continuous with the hyoid bone. Pain during swallowing was thought to be caused by the hyoid bone adhering to the styloid process. The patient’s symptom resolved completely following resection of the process and without any secondary injury via an external excision. In the case of the stalk of the hyperplastic process being attached to the hyoid bone, it is considered that one of the treatment options is removal of the whole body via an external incision. Patients with an elongated styloid process are also referred to as having Eagle’s syndrome. Neck disease occurs in about 4% of cases with the styloid process measuring >25 mm in length. Ossification of the elongated styloid process or spondyloid ligament can cause various symptoms, such as laryngopharyngeal discomfort and pain during swallowing, and ear pain. Therefore, this condition should be borne in mind in the differential diagnosis in patients presenting with laryngopharyngeal discomfort as the main complaint. Surgery would be needed in patients refractory to conservative treatment. In our patient, we performed total excision without secondary injury via an extracervical incision, and the symptoms were improved. There are numerous reports of an elongated styloid process, but reports of cases with an excessively long styloid process that merges with the hyoid bone are rare.