Two cases of symptomatic elongated styloid process

Abstract

Elongation of the styloid process or ossification of the styloid ligament may produce variant symptoms: vague facial pain, throat discomfort, radiated otalgia, dysphagia and so forth.
Two cases of symptomatic elongated styloid process with discomfort of the pharyngeal area and the base of tongue and radiated otalgia are reported in this paper.
Case 1: A 41-year-old man with an ulcer of the base of tongue was referred to us by a dentist on July 25, 1984. He had discomfort of the base of tongue and neuralgic pain on the bilateral temporal area since late 1983. The ulcer was not seen but a hard mass could be palpated in the bilateral tonsillar fossa. Radiographs disclosed gross elongation of the right and left styloid processes.
Clinical diagnosis: Elongated styloid process.
On September 18, 1984, the patient underwent bilateral reduction of the styloid processes by trans-pharyngeal surgical procedure; 3.5 cm of the right process and 4.5 cm of the left one were removed. Histopathologically the two bone pieces showed normal osseous tissue with cortical bone of mature laminar bone.
Postoperatively the patient was free of all previous symptoms.
Case 2: A 31-year-old woman had pain and swelling of posterior region of right auricle, discomfort of pharyngeal area and vomiting since June, 1983. Her neurosurgeon diagnosed the swelling as atheroma with other symptoms resulting from inflammation. As her symptoms continued, she came to our office on July, 11, 1983. At the first visit, the swelling of posterior region of right auricle was not observed and radiographs disclosed abnormal elongation of the right styloid process. Clinical examination of the oral cavity showed reddned mucosa of the right tonsillar fossa. Intraoral palpation of the right tonsillar fossa disclosed a hard, bony cord.
Clinical diagnosis: Elongated styloid process.
We resected 4cm of the process on September 13, 1983. Three months after surgery the patient was free of pain and other previous symptoms.