Otology Japan
Online ISSN : 1884-1457
Print ISSN : 0917-2025
ISSN-L : 0917-2025
Original Article
A rare case of facial palsy associated with elongated styloid process
Misa NakamotoKaoru KusamaMunenaga NakamizoManabu Nonaka
Author information

2023 Volume 33 Issue 3 Pages 197-202


Elongated styloid process can cause various symptoms of discomfort in the laryngopharynx and neck due to overgrowth of the styloid process and ossification of the stylohyoid ligament.

We encountered an extremely rare case of facial nerve palsy that was most likely caused by an elongated styloid process and successfully treated with surgery.

A 30-year-old man presented with a chief complaint of right lower ear pain during swallowing, and computed tomography (CT) showed bilateral elongated styloid processes. Right facial nerve palsy developed a day after the initial visit, and tapered steroid therapy was started on Day 7 of facial palsy onset.

Based on the regional diagnosis and previous reports, the causal site of the right peripheral facial nerve palsy was thought to be peripheral to the bifurcation of the tympanic nerve between the stylomastoid foramen and the base of the styloid process. On Day 13 of onset, the facial nerve score was 8/40 and electroneuronography result was 0%; therefore, facial nerve decompression and styloidectomy were performed.

At 14 months postoperatively, the patient’s facial nerve score was 40/40, and the facial nerve palsy was completely cured. Additionally, the right low ear pain on swallowing had disappeared.

Thus, based on this case and previous reports of elongated styloid process with peripheral facial nerve palsy, facial nerve decompression in addition to styloidectomy can be considered useful for treating facial nerve palsy.

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© 2023 Japan Otological Society
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