Two Cases with an Elongated Styloid Process Surgically Resected Using the Transcervical Approach

Abstract

An elongated styloid process, resulting from abnormal ossification of the stylohyoid ligaments, may cause various symptoms in the head and neck. We report two cases of a giant elongated styloid extending to the hyoid bone, resected using a transcervical approach. Case 1: A 35-year-old woman was referred by the internal medicine department to our department because of neuralgic pain extending from the left submandibular region to the neck. Panoramic radiography and CT revealed a hypertrophied styloid process and ossified styloid ligament extending to the hyoid bone on the left side. The styloid process was 85mm long. Case 2: A 65-year-old man was referred by the otorhinolaryngology department because of pain in the left pharynx. Panoramic radiography and CT revealed a hypertrophied styloid process and ossified styloid ligament extending to the hyoid bone on the left side. The styloid process was 71mm long. There were two sialoliths in the left submandibular gland duct, but no sialolith-related symptoms. An elongated styloid process was diagnosed in both patients and surgically resected via the transcervical approach, without adverse events. Pathological examination of the resected material suggested abnormal calcification of the stylohyoid chain derived from the Reichert cartilage. Symptoms resolved immediately after surgery.