A 33-year-old male with a history of bilateral chronic otitis media was seen with complaints of uncomfortable sensation at the retroauricular area and left shoulder. Digital examination of the left pharyngeal wall revealed a bony protrusion with tenderness at the lower pole of the left tonsil. This finding was highly suggestive of an elongated styloid process. Plain X-rays and laminagrams also indicated the condition.
Under general anesthesia, an external cervical incision was made between the external ridge of the mandible and anterior ridge of m. sternocleidomastoideus. Submaxillary gland and the lower part of the parotid gland were then exposed. The elongated process was searched between these two glands and extirpated.
After the operation the symptoms improved but the patient presented abnormal mandibular movement. Adolfo Bruni and others called this “excellent function of mandible”. The authors attributed this to the injury to the left side of m. stylohyideus, which produced asymmetric movement of the hyoid bone.
This abnormal movement improved gradually.
The elongated styloid process causes various symptoms in the head and neck area as this affects tissues, nerves, and veins in the parapharyngeal space such as the pharyngeal wall, n. glossopharyngeus, n. hypoglossus, cervical sympathetic nerve ganglia, sympathetic nerves, a. carotis and process itself may form ex. pseudoarthrosis.
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