Treatment of Eagle syndrome with transcervical approach secondary to a failed intraoral attempt: Surgical technique and literature review

Abstract

The styloid or Eagle syndrome is characterized by recurrent episodes of pharyngeal pain irradiating in various additional sites of head and neck, owing to an elongated stylohyoid process or calcification of stylohyoid ligament or complex. This article aimed to report a case of surgical treatment of Eagle syndrome by applying transcervical approach for styloidectomy, after a previous but failed intraoral attempt. Aside from the description of the surgical steps of this technique, the current literature was reviewed too. Subsequently to the operation, the patient cited significant resolution of symptomatology from the first postoperative week and remained pain-free the following 6 months. After this follow-up period, the esthetic outcome of the external scar was very satisfactory, without other complications. If not properly diagnosed, patients with Eagle syndrome may receive ineffective or unsuccessful treatments. Secondary to failed intraoral attempt, which results in an elongated residual stump, it is advisable to use transcervical approach for successful resection of the stylohyoid process. In the presented case, the establishment of both adequate exposure and control of neurovascular injury was preoperatively considered essential for dissection in a previously operated field. The selection of either transcervical or intraoral approach is a surgeon-dependent decision, which relies on surgeon's experience, skills, and available equipment and may be influenced by the patient's expectations. Despite the reported disadvantages of transcervical approach, various modifications of this technique have lessened the possible morbid consequences.

Keywords: Eagle syndrome; Stylalgia; Stylohyoid/styloid process neuralgia; Styloid syndrome; Transcervical approach.