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. 2020 Feb;8(4):97.
doi: 10.21037/atm.2019.12.93.

Clinical characteristics and neuroimaging findings in eagle syndrome induced internal jugular vein stenosis

Chaobo Bai  1   2   3 , Zhongao Wang  1   2   3 , Jingwei Guan  1   2   3 , Kexin Jin  1   2   3 , Yuchuan Ding  3   4 , Xunming Ji  2   3   5 , Ran Meng  1   2   3
Affiliations

Clinical characteristics and neuroimaging findings in eagle syndrome induced internal jugular vein stenosis

Chaobo Bai et al. Ann Transl Med. 2020 Feb.

Abstract

Background: Eagle syndrome is a condition that causes pharyngeal pain, facial pain, swallowing difficulties, and symptoms of arterial impingement due to the elongated styloid process. However, few reports were about eagle syndrome with venous compression up to now. This study aimed to identify the clinical profiles of the internal jugular vein stenosis (IJVS) related eagle syndrome comprehensively.

Methods: A total of 27 patients, who were diagnosed as IJVS induced by styloid process compression were enrolled. The clinical manifestations and imaging features were analyzed.

Results: Styloid process compression was presented in all of the 27 IJVS patients, in which, the top three symptoms included insomnia (81.5%), tinnitus (63.0%) and head noises (63.0%). The most vulnerable segment of internal jugular vein (IJV) was J3 segment (96.3%). The average styloid process length in our study was 3.7 cm. Hearing impairment was more common in bilateral IJVS (68.8% vs. 18.2%, P=0.018). One patient reported significant relief of symptoms at 1 year follow-up after underwent styloidectomy combined with stenting.

Conclusions: Neurological symptoms of eagle syndrome induced IJVS were various, including either arterial or venous issues. Better understanding of this disease entity may be helpful for clinical diagnosis and treatment.

Keywords: Internal jugular vein (IJV); eagle syndrome; internal jugular vein stenosis (IJVS); osseous compression; styloid process compression.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
The initial CE-MRV showed severe bilateral IJVS, which was surrounded by abnormally distorted vertebral venous plexuses (A, white arrow). In 3D reconstruction of CT scanning, the J3 segments of the bilateral IJV were obviously compressed by the adjacent lateral mass of C1 and styloid process (B, red arrow). CE-MRV, contrast-enhanced magnetic resonance venography; IJVS, internal jugular vein stenosis.
Figure 2
Figure 2
In 1-year follow-up CTV (A, white arrow) and 3D reconstruction of CT scanning (B, red arrow), it could be observed that the previous left stenotic IJV had restored normal blood flow and the abnormally tortuous vertebral venous plexus was also decreased. CTV, computed tomographic venography; IJV, internal jugular vein.
See this image and copyright information in PMC

References

    1. Kazmierski R, Wierzbicka M, Kotecka-Sowinska E, et al. Expansion of the Classification System for Eagle Syndrome. Ann Intern Med 2018;168:746-7. 10.7326/L17-0507 - DOI - PubMed
    1. Bakshi SS. An Unusually Long Process: Eagle Syndrome. Am J Med 2016;129:1166-7. 10.1016/j.amjmed.2016.05.047 - DOI - PubMed
    1. Morrison RJ, Morrison PJ. Aetiology of Eagle syndrome: ossification of the stylohyoid ligament. QJM 2019;112:467. 10.1093/qjmed/hcy168 - DOI - PubMed
    1. Shah K, Miller DJ. Three-dimensional modeling of Eagle syndrome. Neurology 2016;87:2279-80. 10.1212/WNL.0000000000003365 - DOI - PubMed
    1. Nakagawa D, Ota T, Iijima A, et al. Diagnosis of Eagle syndrome with 3-dimensional angiography and near-infrared spectroscopy: case report. Neurosurgery 2011;68:E847-9. 10.1227/NEU.0b013e318207ac74 - DOI - PubMed