Two Cases of Styloid Process Syndrome Requiring Surgical Treatment Using the Transcervical Approach

Abstract

Elongated styloid processes cause a variety of symptoms in the head and neck, and because of the diverse symptoms, accurate diagnosis may be difficult and appropriate treatment may be delayed. This report describes two cases of giant elongated styloid processes (Eagle’s syndrome). Case 1 was a 21-year-old man who presented with a 6-month history of right neck pain, and Case 2 was a 61-year-old man who presented with a 10-month history of neck pain and sore throat. In both cases, computed tomography revealed elongated styloid processes connecting to the hyoid bone. Surgical treatment using a transcervical approach was undertaken under general anesthesia. After the styloid processes were identified, they were resected and shortened by about 40 mm in Case 1 and by 70 mm in Case 2. Both the patients’ symptoms resolved immediately after the surgery. We suggest that three-dimensional computed tomography (3D-CT) is useful for the diagnosis and for planning the surgical procedure. Transcervical resection of an elongated styloid process is safe and effective, especially when the styloid process is extremely long and associated with complete ossification of the stylohyoid ligament.