Aspectos clínicos, radiográficos e estratégias terapêuticas da Síndrome de Eagle: revisão de literatura / Clinical, radiographic aspects and therapeutic strategies of Eagle Syndrome: literature review

Objetivo: Este trabalho tem como propósito fornecer uma análise abrangente das características anatômicas, clínicas e radiográficas da Síndrome de Eagle, além de abordar os métodos de diagnóstico e estratégias terapêuticas. Materiais e métodos: Foi realizada uma busca por artigos científicos publicados no período de 2016 a 2024, utilizando as bases de dados Scientific Electronic Library Online (SciELO), US National Library of Medicine (PubMed) e Google Scholar. A coleta de artigos foi realizada nos idiomas inglês e português, utilizando as palavras-chave: "síndrome de eagle", "síndrome estiloide", "síndrome da artéria carótida", "estilalgia", "eagle syndrome", "styloid syndrome", "carotid artery syndrome" e "stylalgia". Conclusão: Os profissionais devem estar atentos à síndrome de Eagle em casos de dor unilateral ao realizar atividades como engolir, bocejar e chorar, sem causa aparente, especialmente em mulheres adultas que não encontram alívio com analgésicos. Devido à frequência de casos assintomáticos, a realização precoce de exames radiológicos desempenha um papel crucial na avaliação diagnóstica. É essencial que profissionais de Otorrinolaringologia, Neurologia e Odontologia estejam cientes dessa síndrome, pois está associada a uma significativa deterioração na qualidade de vida. (AU)

Objective: This work aims to provide a comprehensive analysis of the anatomical, clinical and radiographic characteristics of Eagle Syndrome, in addition to addressing diagnostic methods and therapeutic strategies. Materials and methods: A search was carried out for scientific articles published between 2016 and 2024, using the Scientific Electronic Library Online (SciELO), US National Library of Medicine (PubMed) and Google Scholar databases. Articles were collected in English and Portuguese, using the keywords: "eagle syndrome", "styloid syndrome", "carotid artery syndrome", "stilalgia", "eagle syndrome", "styloid syndrome", "carotid artery syndrome" and "stylalgia". Conclusion: Professionals should be aware of Eagle syndrome in cases of unilateral pain when performing activities such as swallowing, yawning and crying, without an apparent cause, especially in adult women who do not find relief with analgesics. Due to the frequency of asymptomatic cases, early radiological examinations play a crucial role in diagnostic evaluation. It is essential that Otorhinolaryngology, Neurology and Dentistry professionals are aware of this syndrome, as it is associated with a significant deterioration in quality of life. (AU)

Actualización sobre el síndrome de Eagle y sus complicaciones neurocardiológicas: casos clínicos / An update on Eagle´s syndrome and its neuro-cardiological complications: clinical cases

El síndrome de Eagle o síndrome estilohioideo o sín-drome de la arteria carótida es un trastorno que se origina por la mineralización y elongación del pro-ceso estiloides. Factores traumáticos agudos y cró-nicos, así como otras teorías, han sido propuestos para explicar la etiología y patogenia de esta altera-ción. El conjunto de síntomas puede incluir: dolor fa-ríngeo, odinofagia, disfagia, cefalea, con irradiación a oreja y zona cervical. Si bien existen varias clasifi-caciones, de manera universal se acepta que existen principalmente dos formas de presentación de esta patología: el tipo I o clásico, generalmente asociado a un trauma faríngeo y acompañado de dolor en la zona faríngea y cervical, y el tipo II o carotídeo, que sue-le presentar molestia cervical, cefalea y alteración de la presión arterial, con riesgo de daño de la ac-tividad cardíaca. La identificación de este síndrome suele ser confusa dada la similitud de los síntomas con otras afecciones. El diagnóstico debe realizarse en base a los síntomas y a los estudios por imágenes específicos. El tratamiento puede ser conservador y actuar simplemente sobre los síntomas, o bien, qui-rúrgico. El objetivo del presente trabajo es realizar una revisión actualizada de la literatura sobre el sín-drome de Eagle y presentar tres casos clínicos con distintas manifestaciones (AU)

Eagle's syndrome or styloid syndrome or stylo-carotid artery syndrome is a disease caused by mineralization and elongation of the styloid process. Acute and chronic traumatic factors, along with other hypothesis, have been proposed to explain the aetiology and pathogenesis of this condition. Symptoms can include: pharynx pain, odynophagia, dysphagia, headache, with radiating pain to the ear and neck. Despite there are several classifications, it is universally accepted that this pathology can present in two forms: the type I or classic, generally associated to tonsillar trauma and characterized by pharyngeal and neck pain, and the type II or carotid artery type, which frequently presents with neck pain, headache, blood pressure variation, with risk of damage to cardiac function. Identifying of Eagle's syndrome is often confusing because some symptoms are shared with other pathologies. Diagnosis must be made on the basis of symptoms and imaging studies. Treatment can be conservative, acting only on symptoms, or surgical. The aim of this paper is to provide an updated review of the literature on Eagle syndrome and to present three clinical cases with different manifestations (AU)

Concomitant Ulnar Styloid Fractures in Distal Radius Osteosynthesis Does Not Impact Radiographic Outcomes, Ulnar Sided Symptoms and Patient Outcomes

@#Introduction: Current literature reports varied significance of ulnar styloid fractures (USF) associated with distal radius fractures. Our study assesses the role of ulnar styloid fractures and fragment size in surgically managed distal radius fractures. Materials and methods: We reviewed patients who underwent surgical fixation of distal radius fractures between January 2004 to June 2006. Patients were divided into those with (Group 1) and without (Group 0) USFs. Post-operative radiographic parameters, clinical outcomes and overall wrist function were analysed. Outcomes included ulnar-sided wrist pain, extensor carpi ulnaris (ECU) tendinitis, triangular fibrocartilage complex (TFCC) grind test, distal radioulnar joint (DRUJ) instability and pain. Overall wrist function was assessed with range of motion and Disabilities of the Arm, Shoulder and Hand (DASH) score. Results: Our study cohort included 31 males and 23 females, and 38.9% of these patients had concomitant USFs. There was no difference in terms of demographic data and fracture configuration between groups. Radiographic parameters were similar, except for palmar tilt, which was significantly higher in Group 1 (4.6º vs 9.4º, p=0.047). At 24 months, there were no differences in clinical outcomes and overall wrist function. A sub-group analysis showed that mean USF fragment size was larger in patients with a positive TFCC grind test (3.9mm vs 7.3mm, p=0.033). Conclusion: The presence of USFs in surgically managed distal radius fractures does not compromise clinical and functional outcome. Similarly, the size of USFs does not impact clinical and functional outcome but is associated with the presence of a positive TFCC grind test.

Abordaje transcervical en el síndrome de Eagle. Reporte de caso clínico / Transcervical Approach in Eagle Syndrome. Clinical Case Report

Resumen El síndrome de Eagle es una enfermedad rara responsable de múltiples síntomas de cabeza y cuello, resultado de un alargamiento del proceso estiloideo u osificación del ligamento estilohioideo comprimiendo estructuras neurovasculares adyacentes, hay dos variantes, el clásico caracterizado principalmente por dolor y disfagia y la variante carotídea distinguido con dolor y en ocasiones isquemia cerebral. Describimos un reporte de caso clínico de un paciente femenino de 45 años, quien experimentaba dolor cervical de lado izquierdo, realizando el protocolo completo de dolor miofascial del Hospital Regional General Ignacio Zaragoza ISSSTE de la Ciudad de México, el estudio de tomografía computada evidenció una elongación de 50mm del proceso estiloideo, confirmando el diagnóstico, enfocando el artículo en la descripción anatómico-quirúrgica.

Abstract Eagle syndrome is a rare disease responsible for multiple head and neck symptoms, resulting from an elongation of the styloid process or ossification of the stylohyoid ligament compressing adjacent neurovascular structures. There are two variants, the classic one characterized mainly by pain and dysphagia and the carotid variant distinguished with pain and sometimes cerebral ischemia. We describe a clinical case report of a 45-year-old female patient, who experienced left cervical pain, performing the complete myofascial pain protocol of the Regional Hospital "General Ignacio Zaragoza" ISSSTE in Mexico City, resulting in a 50mm elongation of the styloid process in the CT scan, confirming the diagnosis, and focusing the article on the anatomical-surgical description.

Types of ulnar styloid process fracture and treatment of distal radius fracture / 中华创伤骨科杂志

Objective:To investigate the effects of types of ulnar styloid process fracture on the treatment of distal radius fracture.Methods:The 80 patients were analyzed retrospectively who had been treated at The First Department of Hand Surgery, Honghui Hospital from January 2019 to January 2020 for fracture of distal radius complicated with fracture of ulnar styloid process. They were 25 males and 55 females, aged from 30 to 85 years (average, 58.6 years). According to the types of ulnar styloid process fracture, 40 patients were assigned into a Hauck type Ⅰ group and the other 40 into a Hauck type Ⅱ group. The 2 groups were compared in terms of operation, postoperative complications, hospital stay, bone union, visual analogue scale (VAS) on postoperative 1 to 3 days, and modified Mayo wrist function score, wrist range of motion and quality of life by WHOQOL-BREF at the last follow-up.Results:The 2 groups were comparable because there was no significant difference in age, gender, American Society of Anesthesiologists (ASA) rating, or time from injury to operation between them ( P>0.05). All the patients were followed up for 12 to 24 months (average, 17 months). There was no significant difference between Hauck type Ⅰ group and Hauck type Ⅱ group in operation time, intraoperative blood loss, hospital stay, rate of postoperative complications, fracture union, modified Mayo wrist function score or VAS on postoperative 1 to 3 days ( P>0.05). At the last follow-up, the palm tilt and ulnar inclination angles were 13.8°±1.9° and 21.6°±2.8° in Hauck type Ⅰ group, significantly larger than those in Hauck type Ⅱ group (11.9°±1.6° and 18.8°±2.3°) ( P<0.05). At the last follow-up, Hauck Ⅰ group scored 85.3±6.4,85.6±6.5, 84.7±6.3 and 85.0±6.7 respectively in the domains of physical health, psychology, environment and social relationships, significantly higher than those Hauck type Ⅱ group did (78.5±6.5, 78.9±6.5, 77.8±6.1 and 77.9±6.3) ( P<0.05). Conclusions:In open reduction and internal fixation for distal radius fracture, Hauck Type Ⅰ fracture of ulnar styloid process has no significant effect on the functional recovery of the wrist but Hauck Type Ⅱ fracture of ulnar styloid process may. Therefore, surgical fixation needs to be strengthened if Hauck Type Ⅱ fracture of ulnar styloid process is complicated.

Effect of internal carotid artery aberrations on the distance between styloid process and carotid artery / Efecto de las variaciones de la arteria carótida interna en la distancia entre el proceso estiloides y la arteria carótida

SUMMARY: The objective of this study was to evaluate the role of the variations of carotid artery course on the relationship between styloid process (SP) and internal carotid artery (ICA). Carotid CT angiography scans of 170 patients were retrospectively evaluated. The variability of the course of ICA were classified. The length and medial angulation of the SP were measured on coronal 3D images. On axial images, the shortest distance between the bone edge of the SP and ICA were measured. The distance between SP and ICA among the course patterns of carotid artery were compared statistically. In the comparison of distances between SP and ICA with respect to the course of ICA, the difference between straight and curving (p <0.001) was statistically significant. Curving caused the separation of ICA and SP. The highest and the shortest distance was at the curving and coiling group, respectively. We found that SP-ICA distance has a positive and negative correlation with SP angle (p<0.001) and SP length (p<0.001), respectively. The course of ICA is one of the major determinants affecting the relationship of ICA and SP. The curving pattern of ICA has a tendency to increase the distance between SP and ICA.

RESUMEN: El objetivo de este estudio fue evaluar el rol de las variaciones que tiene el curso de la arteria carótida en la relación entre el proceso estiloides (PE) y la arteria carótida interna (ACI). Se evaluaron retrospectivamente angiografías por tomografía computarizada carotídea de 170 pacientes. Se clasificó la variabilidad del curso de ACI. Se midieron en imágenes coronales y en 3D la longitud y la angulación medial del PE. En las imágenes axiales, se midió la distancia más corta entre el margen del PE y la ACI. Se comparó estadísticamente la distancia entre PE y la ACI entre los patrones de trayecto de la arteria carótida. La comparación de las distancias entre PE y la ACI respecto al curso de ACI, fue estadísticamente significativa, siendo la diferencia entre arterias recta y curva (p <0,001). La arteria curva provocó la separación de la ACI y del PE. Las mayores y menores distancias estaban en el grupo de arterias curvas y enrolladas, respectivamente. La distancia PE-ACI tiene una correlación positiva y negativa con el ángulo PE (p <0,001) y la longitud del PE (p <0,001), respectivamente. El curso de la arteria carótida interna es uno de los principales determinantes que afectan la relación con el proceso estiloides. El patrón de curva de la ACI tiende a aumentar la distancia entre PE y la propia arteria arteria.

Resección transoral de la apófisis estiloides por síndrome de Eagle: caso clínico / Transoral resection of the stiloyd process for Eagle síndrome: case report

El síndrome de Eagle está caracterizado por una elongación o una curvatura medial excesiva de la apófisis estiloides o por una calcificación del ligamento estilohioideo que puede provocar dolor cervicofacial o síntomas neurológicos por la compresión de los vasos o nervios del cuello. El tratamiento más eficaz es el quirúrgico y consiste en la resección de la apófisis estiloides; puede ser realizado por vía externa o mediante un abordaje transoral. Se describe el caso clínico de un paciente con síndrome de Eagle que fue tratado con éxito mediante un abordaje transoral, sin amigdalectomía y con asistencia de endoscopios. (AU)

Eagle syndrome is characterized by an elongation or excessive medial curvature of the styloid process or calcification of the stylohyoid ligament that can cause cervicofacial pain or neurological symptoms due to compression of the vessels or nerves of the neck. The most effective treatment is surgical and consists of resection of the styloid process, it can be performed by externally or through a transoral approach.The clinical case of a patient with Eagle syndrome who was successfully treated by a transoral approach, without tonsillectomy and with the assistance of endoscopes, is described. (AU)

Mineralización del complejo estilohioideo en una población de Cuenca-Ecuador / Mineralization of the stylohyoid complex in a population from Cuenca-Ecuador

RESUMEN El complejo estilohioideo es una estructura ósea y ligamentosa, formada por varias entidades anatómicas como: la apófisis estiloides, el ligamento estilohioideo y el cuerno menor del hioides. La apófisis estiloides se origina en la porción timpánica del hueso temporal y mide en promedio 25 mm; en ocasiones puede encontrarse aumentada en longitud, situación que puede o no manifestarse con dolor. Objetivo: determinar la prevalencia de mineralización del complejo estilohioideo de pacientes de Ecuador mediante radiografías panorámicas digitales. Material y Métodos: Para ello se analizaron 2025 radiografías panorámicas digitales de pacientes de ambos sexos, de edades entre 12 a 92 años, del período comprendido entre los años 2015-2016. Se consideró como complejo estilohioideo mineralizado, cuando este sobrepasaba los 25mm. Resultados: Se observaron 2025 radiografías panorámicas,de las cuales 1206 (59,6%) radiografías, mostraron algún tipo de mineralización del complejo estilohioideo. De estas 1288 (63,6%) pertenecen al sexo femenino y 737 (36,4%) al sexo masculino. La presentación más frecuente fue bilateral. Además, se encontró que en los adultos mayores la prevalencia alcanzaba el 76%. Conclusiones: En el presente estudio se muestra que existe una alta prevalencia de mineralización del complejo estilohioideo en la población estudiada.

SUMMARY The stylohyoid complex is a bony and ligamentous structure, formed by several anatomical entities such as the styloid process, the stylohyoid ligament and the horn of the hyoid. The styloid process originates in the tympanic portion of the temporal bone and measures an average of 25 mm; sometimes it may be increased in length, a situation that may or may not have pain itself. Objective: To determine the prevalence of mineralization of the stylohyoid complex of patients at the country of Ecuador using digital panoramic radiographs. Material and methods: Analysis of 2025 digital panoramic radiographs of patients of both sexes, between 12 and 92 years of age, from the period 2015-2016. It was considered as mineralized stylohyoid complex, when it exceeded 25mm. Results: Of the 2025 panoramic radiographs, it was concluded that 1206 (59.6%) radiographs showed some type of mineralization of the stylohyoid complex. Of these 1288 (63.6%) belong to the female sex and 737 (36.4%) to the male sex. The most frequent presentation was bilateral. In addition, it was found that in older adults the prevalence reached 76%. Conclusions: In the present study it is shown that there is a high prevalence of mineralization of the stylohyoid complex in the population studied.

Establishment and mechanical analysis of the finite element model of the type frykman VIII fracture of the distal radius with steel plate fixation / 中国组织工程研究

BACKGROUND: Generally, the treatment of distal radius fractures or joint dislocations is generally valued in clinical practice, but little attention is paid to the ulnar styloid fracture, and whether the ulnar styloid fracture needs to be fixed is controversial. In the study of orthopedic biomechanics, the selection of cadaver model may encounter some problems, such as different selection criteria of cadaver model and different mechanical measurement methods. OBJECTIVE: Based on Mimics software, the finite element simulation model of type Frykman VIII fracture of the distal radius fixed by plate and screw was constructed using finite element analysis. The working condition and load were set for mechanical analysis. It is hoped to provide a reference for the choice of the repair plan of this kind of fracture. METHODS: A three-dimensional finite element model of normal wrist joint was established based on the forearm and wrist CT images of a healthy volunteer. After debugging the model, Von Mises stress of the distal radius was obtained by loading the 100 N stress in the axial direction, and the validity of the model was verified by comparing with the experimental data in the literature. Two kinds of finite element models of Frykman VIII fracture with ulnar styloid type I and type II fractures were established by using finite element software to divide the mesh, cut and mold, and the model of plate and screw fixation of distal radius was assembled. Setting load under rotating working conditions, we analyzed the changes of the stress distribution of the steel plate unit in two models, and the relative displacement of the distal radioulnar joint as well as the ulnar styloid fracture broken end. RESULTS AND CONCLUSION: (1) A three-dimensional finite element model of normal wrist joint was established and validated, and the other two models of type Frykman VIII fracture of the distal radius with ulnar styloid type I and type II fractures fixed by plate and screw were established based on this model. (2) Under the same rotating load, this study showed that the stress and stress distribution of the steel plate unit in the steel plate fixation model of Frykman VIII fracture of the distal radius combined with ulnar styloid type I fracture were smaller than those of the fracture model combined with type II fracture of styloid process of ulna; the relative displacement values of the distal radioulnar joint and the ulnar styloid fracture broken end were smaller than the latter too. (3) The three-dimensional finite element model of wrist joint constructed in this study can be used to analyze the mechanical mechanism of wrist fracture. The results of finite element analysis showed that the fracture of styloid process of ulna in Frykman VIII fracture of the distal radius would affect the stability of the distal radioulnar joint, especially in the case of ulnar styloid type II fracture, which can provide a certain clinical reference for the selection of operation scheme of such fracture.

Effects of ulnar styloid and sigmoid notch fractures on postoperative wrist function of patients with distal radius fracture / 北京大学学报(医学版)

OBJECTIVE@#To study the effects of ulnar styloid and sigmoid notch fractures on postoperative wrist function in patients with distal radius fracture.@*METHODS@#In total, 139 patients treated for distal radius fracture in the Department of Orthopedic Trauma at Peking University People's Hospital from Jan. 2006 to June 2016 were selected for outpatient follow-ups. Evaluation was based on Sartiento's modification of the Gartland and Werley scores. Efficacy was assessed with wrist pain as the focus.@*RESULTS@#The excellent and good efficacy rate was 97.1% (excellent: n=107, 77.0%; good: n=28, 19.4%; and fair: n=4, 2.9%). Gender, age, and whether the ulnar styloid fracture achieved union did not significantly impact the scores (P>0.05). The scores of the basal fracture group were significantly different (P=0.001). Internal fixation of ulnar styloid fracture was associated with a significant difference in scores (P=0.005). The effect of sigmoid notch fracture was also associated with a significant difference in scores (P=0.024). This study included 22 cases of ulnar wrist pain, and the overall incidence of ulnar wrist pain was 15.8%. Gender, age, whether the ulnar styloid fracture achieved union, and whether internal fixation was conducted for ulnar styloid fracture and sigmoid notch fracture had no significant effect on the occurrence of ulnar wrist pain (P>0.05). The incidence of ulnar wrist pain was higher in basal fractures than that in tip fractures. Among ulnar styloid fractures, the union rate of basal fracture was higher than that of tip fractures. The union rates of basal fracture and tip fracture were significantly different (P<0.001). Basal fractures were significant risk factors for ulnar wrist pain (P=0.028). Basal fracture of the ulnar styloid group and sigmoid notch fracture group had poor wrist function scores. Wrist function score improved significantly after internal fixation of ulnar styloid fracture. The incidence of ulnar wrist pain was higher in basal fracture group. The union rate in basal fracture group was higher than in tip fracture group.@*CONCLUSION@#The overall effect of surgical treatment of distal radius fracture is satisfactory. Ulnar styloid basal fracture and sigmoid notch fracture are risk factors for postoperative wrist dysfunction in patients with distal radius fracture, and the basal fracture is one of the risk factors of ulnar wrist pain. The union rate of ulnar styloid basal fractures is better than that of tip fractures. Internal fixation of ulnar styloid fracture can improve wrist function.

Ictus isquémico y disección bilateral de la arteria carótida interna: una manifestación rara del síndrome de eagle: reporte de un caso / Ischemic stroke and bilateral dissection of the internal carotid artery: a rare manifestation of the eagle syndrome: a case report

RESUMEN Un síndrome caracterizado por dolor cervical y un apófisis estiloides alargado fue descrito por primera vez por Watt Eagle en 1937. Aunque el síndrome de Eagle en su variante vascular es raro y no es reconocido como causa clara de disección carotídea, en los últimos años ha sido reportado un incremento del número de casos de disección carotídea causada por una apófisis estiloides alargada. Paciente de 56 años que acudió al servicio de urgencias por paresia facial izquierda aguda y habla confusa. Presentaba dolor cervical de dos días de evolución, relacionado con un ataque de tos. Se activó el código ictus y la tomografía computarizada (TC) mostró isquemia del lóbulo temporal derecho y disección bilateral de la arteria carótida interna. La angio-TC de los troncos supraaórticos con reconstrucción tridimensional, identificó una apófisis estiloides alargado en ambos lados. El paciente fue sometido a una angioplastía con colocación de dos stents. Debido al alto riesgo de padecer nuevo ictus, se decidió realizar tratamiento quirúrgico. Para el lado derecho se realizó un abordaje transoral y en el izquierdo un abordaje abierto. La apófisis estiloides alargado es una causa importante de disección carotídea y de las complicaciones cerebrovasculares relacionadas.

ABSTRACT A syndrome characterized by cervical pain and an abnormally elongated styloid process was first described by Watt Eagle in 1937. Even though vascular Eagle syndrome is uncommon and is not well recognized as a cause for carotid artery dissection, in the last few years there have been an increasing number of case reports of carotid artery dissection caused by an elongated styloid process. A 56 years old man presented to the emergency department with acute left facial weakness and slurred speech. He complained of two days neck pain, related to a coughing fit. The code stroke protocol was activated and imaging showed a right temporal bone stroke and a bilateral internal carotid artery dissection. A scan angiography of the supra-aortic vessels with 3D reconstruction was performed showing a bilateral abnormally elongated styloid process. The patient underwent angioplasty with two stent placements. Due to the high risk of recurrent strokes, the patient was evaluated in the otolaryngology department for styloid process resection. Finally a transoral approach for the right side and an open approach for the left side were performed. We have to consider an elongated styloid process as an important cause of carotid artery dissection and subsequent cerebrovascular complications

Research progress of stenosing tenosynovitis of radial styloid process based on anatomical structure / 中国骨伤

Stenosing tenosynovitis of styloid process of radius(de Quervain's disease) which abductor pollicis longus and extensor pollicis brevis in the first extensor chamber are affected by resistance when sliding, the incidence is affected by anatomical variations. Symptoms, signs and auxiliary examinations can diagnose the disease. Slight dQS can be improved by rest, brace, restriction activities, and oral medications. Chinese medicine and physiotherapy also reduce the disease. Needle knife therapy is a Traditional Chinese medicine minimally invasive surgery, which is also a step-by-step treatment between conservative treatment and open surgery to loosening the compression of the first extensor chamber. Steroid injection is a more common treatment in this disease, and its efficacy is related to the accuracy of the injection and is affected by the severity of the patient's anatomical variation. Identifying the spacing within the first extensor chamber under ultrasound can help patients better choose conservative or surgical treatment. Surgical treatment can more completely change the condition of dQD from anatomical structure, and clinical should pay attention to the choice of surgical procedure to improve the efficacy and reduce the occurrence of surgical complications. This article discusses the pathogenesis, diagnosis and treatment of the disease from the perspective of anatomical structure. It mainly analyzes the therapeutic targets and the clinical application, which aims to provide reference for the diagnosis and treatment of de Quervain disease.

Cervico-stylo-mandibular complex fracture: a critical review of literature along with a protocol to recognize and proposal of a new classification

Fractures of the styloid process of the temporal bone may occur with or without an obvious relation to trauma. The incidence of either isolated styloid process fracture or in combination with mandibular fractures is rare, and such occurrences are often misdiagnosed or neglected. A fractured styloid when displaced may impinge on adjacent vital structures, leading to neurological or vascular symptoms that vary according to the anatomical structure compressed. Styloid process fractures associated with atlas/C1 fractures have also been rarely reported in the literature. In this review of literature, the majority of patients was treated conservatively, as few demonstrated the necessity of surgical intervention. There is a definitive need for a protocol to recognize and classify styloid fractures to plan for further treatment. The aim of this review was to achieve a comprehensive understanding of all types of styloid fractures, determine the clinical severity of symptoms, and to consider management and prognosis. In addition, a new classification of cervico-stylo-mandibular fractures is proposed based on important evidence in the literature regarding clinical and radiographic factors that might influence the treatment and prognosis of such fractures.

Hybrid operation for stylocarotid artery syndrome: A case report and literature review / 中国脑血管病杂志

Stylocarotid artery syndrome is a rare condition resulted from compression of the internal or external carotid artery by the styloid process of temporal bone. Patient was presented with left limbs weakness, then compression of the right carotid artery by elongated styloid process was found. He was treated by styloid process truncation with hybrid technique. After operation, compression of carotid artery was relieved. No arterial perforation or dissection happened. This case demonstrated that treatment of carotid artery stylocarotid syndrome with hybrid operation that combines endovascular techniques, radiological imaging and surgical resection can be minimally invasive, safe and effective.

Síndrome de eagle: reporte de caso / Eagle syndrome: case report / Síndrome de eagle: relato de caso

Resumen El síndrome de Eagle se considera como la elongación del proceso estiloides con osificación del ligamento estilohioideo o sin él, que se extiende entre el hueso temporal y el hioides. El diagnóstico puede ser realizado principalmente con tomograña computarizada (TC) o radiografía panorámica, por su puesto sin dejar de lado la variedad de signos y síntomas, como dolor cervical, sensación de cuerpo extraño en la faringe, limitaciones en la apertura bucal, dificultad para la fonación, disfagia, otalgia, tinnitus, trismo y movilidad reducida del cuello. Ya identificada la elongación, el paciente podrá recibir un tratamiento conservador o quirúrgico dependiendo de la severidad de los síntomas. El manejo conservador incluye fisioterapia, infiltración con anestésicos locales o corticosteroides y el tratamiento con fármacos antiinflamatorios, anticonvulsivos o antidepresivos. El manejo quirúrgico consiste en fracturar el proceso estiloides bajo anestesia general, a través de abordajes transorales o transcervicales. A continuación, expondremos información pertinente sobre el síndrome de Eagle y posteriormente presentaremos un caso clínico de una paciente con dicho síndrome del servicio de Cirugía Oral y Maxilofacial del Hospital Militar Central.

Abstract Eagle syndrome is considered as the elongation of the styloid process with or without ossification of the stylohyoid ligament, which extends between the temporal bone and the hyoid. The diagnosis can be made mainly with computed tomography (CT) or panoramic radiography, of course without neglecting the variety of signs and symptoms, such as cervical pain, foreign body sensation in the pharynx, limitations in oral opening, difficulty in phonation, dysphagia, otalgia, tinnitus, trismus and reduced neck mobility. Once the elongation has been identified, the patient may receive conservative or surgical treatment depending on the severity of the symptoms. Conservative management includes physiotherapy, infiltration with local anesthetics or corticosteroids and treatment with anti-inflammatory, anticonvul sant or antidepressant drugs. Surgical management consists in fracturing the styloid process under general anesthesia, through transoral or transcervical approaches. Next, we will present pertinent information about the Eagle syndrome and then we will present a clinical case of a patient with said syndrome of the Oral and Maxillofacial Surgery service of the Hospital Militar Central.

Resumo A síndrome de Eagle considera-se como o alongamento do processo estiloide com ossificação do ligamento estilo-hioideo ou sem ele, que se estende entre o osso temporal e os hioides. O diagnóstico pode ser realizado principalmente com tomografia computadorizada (TC) ou radiografia panorâmica, obviamente sem deixar de lado a variedade de sinais e sintomas, como dor cervical, sensação de corpo estranho na faringe, limitações na abertura bucal, dificuldade para a fonação, disfagia, otalgia, zumbido, trismo e mobilidade reduzida do pescoço. Já identificado o alongamento, o paciente poderá receber um tratamento conservador ou cirúrgico dependendo da gravidade dos sintomas. O tratamento conservador inclui fisioterapia, infiltração com anestésicos locais ou corticosteroides e o tratamento com fármacos anti-inflamatórios, anticonvulsivos ou antidepressivos. O tratamento cirúrgico consiste em fraturar o processo estiloide sob anestesia geral, por meio de abordagens intraorais ou transcervicais. A seguir, exporemos informação pertinente sobre a síndrome de Eagle e, posteriormente, apresentaremos um caso clínico de uma paciente com essa síndrome do serviço de Cirurgia Oral e Maxilofacial do Hospital Militar Central.

An Abnormally Long Styloid Process With Ossification Of The Stylohyoid Ligament

The styloid process of the temporal bone is an elongated bony projection presenting a variable length asdemonstrated in osteometric and radiological studies conducted with different techniques: three-dimensionalcomputed tomography (3dct) or dental panoramic three-dimensional scanning. An elongated styloid processcan cause neck pain , dysphagia, headache, sore throat, ear pain, mandibular dysfunction which characterizeEagle’s syndrome. Here we present a rare image of an abnormally long styloid process with ossification of leftstylohyoid ligament belonging to a bone collection of the local anatomical museum , part of our department,and discovered during routine osteology classes .Also if a direct relation between the length of the styloidprocess and syndrome of Eagle is not always obvious ,radiologists , neurologists,neurosurgeons, dentists,anesthetists and otolaryngologists could be aware of this bone anomaly to diagnose this syndrome

Dolor cervical atípico: síndrome de Eagle / Atypical neck pain: Eagle syndrome

Presentamos el caso de un varón de 45 años con dolor cervical derecho muy localizado, característico y persistente. El estudio radiológico nos permitió diagnosticar claramente un síndrome de Eagle. Por lo anterior el paciente fue sometido a cirugía de extirpación de apófisis estiloides derecha. El paciente evolucionó sin mayores complicaciones ni incidencias, y obteniendo la resolución del cuadro.

Here we introduce a 45-year-old man suffering from an intense, unique and permanent pain, located in his right neck. Radiology showed us signs leading to the diagnosis of Eagle Syndrome. Surgery of right Styloid apophysis removal, with no complications, letting the patient free of symptoms.

Clinical Observation of External Application of Wentong Paste Plus Local Block Therapy for Treatment of Stenosing Tendovaginitis at Radial Styloid / 广州中医药大学学报

Objective To observe clinical curative effect of the external application of Wentong Paste plus local block therapy for the treatment of stenosing tendovaginitis at radial styloid. Methods A total of 108 cases of patients with stenosing tendovaginitis at the radial styloid were randomly divided into local block therapy group, combination group and Wentong Paste group, 36 cases in each group. The local block therapy group was given injection of blocking liquid into the tendon sheath, combination group was given external application of Wentong Paste(mainly composed of Radix Angelicae Sinensis, Fructus Psoraleae, Radix Angelicae Pubescentis, and Rhizoma et Radix Notopterygii) plus local block therapy, and Wentong Paste group was only given external application of Wentong Paste. Before treatment and after treatment for one and 2 week(s), visual analogue scale (VAS) scores of pain and range of motion (ROM) of wrist joint were observed for the evaluation of clinical effectiveness and safety. The patients were followed up for 3 months for the assay of recurrence rate. Results (1) After treatment for one week, the total effective rate of local block therapy group, combination group and Wentong Paste group was 77.8%, 100.0%, 72.2%respectively, and the total effective rate after treatment for 2weeks was 86.1%, 100.0%, 86.1% respectively. The combination group had better clinical efficacy than local block therapy group and Wentong Paste group (P < 0.05). (2) After treatment for one and 2 week (s), VAS scores of the 3 groups were obviously increased while ROM was much increased (P < 0.05 compared with those before treatment). The combination group had the lowest VAS scores and highest ROM(P < 0.05).(3) No adverse reaction was found in the 3 groups during the treatment. (4) The 3 month follow-up results showed that the recurrence rate of the three groups was 30.61%, 10.20%, 20.41% respectively, and the combination group had the lower rate than local block therapy group and Wentong Paste group(P<0.05). Conclusion The external application of Wentong Paste plus local block therapy is effective for the treatment of stenosing tendovaginitis at radial styloid by relieving pain, increasing the ROM, and reducing the recurrence rate. The one-week efficacy of Wentong Paste alone was inferior to that of local block therapy alone, but their two-week efficacy showed no obvious difference. Moreover, Wentong Paste has an obvious advantage in reducing the recurrence rate.

Sexual dimorphism using the interstyloid distances and clinical implication for elongated styloid process in Northeastern Thailand / Dimorfismo sexual usando la distancia inter-estiloide y la implicación clínica del proceso estiloides elongado en el Noreste de Tailandia

Skeletal remains are crucial in forensic identification of the sex, especially human skulls including the styloid process, a bony projection from the skull. Hence, the objectives of the present study were undertaken to assess the value of the styloid process for the sex identification of unknown skulls and also to investigate the prevalence of elongated styloid process in 102 human dry skulls from the northeast Thai population. As a result, the interstyloid distances at both base and tip of the styloid processes were found to be significantly different between male and female specimens, although no significant difference was found in the length of the styloid process between males and females. In addition, the occurrence of the elongated styloid process was not associated with the gender, although its prevalent laterality on the left was recognized. It is suggested that the styloid process can be applied to the sex identification by measuring the interstyloid distance at the base or the tip of these processes.

Los restos óseos son cruciales para la identificación forense del sexo, especialmente en los cráneos humanos, incluyendo el proceso estiloides, una proyección ósea del cráneo. Por lo tanto, los objetivos del presente estudio consistieron en evaluar el valor del proceso estiloides en la identificación del sexo de cráneos desconocidos y también para investigar la prevalencia del proceso estiloides elongado en 102 cráneos secos humanos de la población del Noreste de Tailandia. Como resultado, se encontró que las distancias inter-estiloides tanto en la base y la punta de los procesos estiloides eran significativamente diferentes entre las muestras de hombres y mujeres, aunque no se encontró diferencia significativa en la presencia del proceso estiloides entre ambos. Además, la aparición del proceso estiloides elongado no se asoció con el sexo, aún cuando se observó su prevalencia en el lado izquierdo. Sugerimos que el proceso estiloides se puede utilizar en la identificación del sexo mediante la medición de la distancia inter-estiloide en la base o en la punta de estos procesos.

Eagle syndrome: a narrative review / Síndrome de Eagle: una revisión narrativa

Abstract: painful disorders in the maxillofacial region are common in dental practice. Most of these conditions are not properly diagnosed because of inadequate knowledge of craniofacial and cervico-pharyngeal syndromes such as Eagle Syndrome. The aim of this review is to describe the general aspects, diagnosis and treatment of Eagle syndrome. Eagle syndrome or stylohyoid syndrome was first described by Watt W. Eagle in 1937. It was defined as orofacial pain related to the elongation of the styloid process and ligament stylohyoid calcification. The condition is accompanied by symptoms such as dysphonia, dysphagia, sore throat, glossitis, earache, tonsillitis, facial pain, headache, pain in the temporomandibular joint and inability to perform lateral movements of the neck. Diagnosis and treatment of Eagle syndrome based on symptoms and radiographic examination of the patient will determine the need for surgical or nonsurgical treatment. Eagle syndrome is a complex disorder demanding a thorough knowledge of its signs and symptoms to make a correct diagnosis and provide an appropriate subsequent treatment. Disseminating information about this syndrome among medical-dental professionals is essential to provide adequate dental care to patients.

Resumen: en la práctica odontológica, es frecuente encontrar alteraciones con sintomatología dolorosa en la región maxilofacial, las cuales no son apropiadamente diagnosticadas, a causa del desconocimiento de síndromes craneofaciales y cervicofaríngeos, como el Síndrome de Eagle. El objetivo de esta revisión es describir los aspectos generales, diagnóstico y tratamiento del Síndrome de Eagle. El Síndrome de Eagle o estilalgia es la entidad nosológica, descrita por Watt W. Eagle en 1937, definida como aquel dolor orofacial relacionado con la elongación de la apófisis estiloides y calcificación del ligamento estilohioideo; el cual está acompañado de síntomas como: disfonía, disfagia, dolor faríngeo, glositis, otalgia, tonsilitis, dolor facial, cefalea, odinofagia, dolor en la articulación temporomandibular e imposibilidad de realizar movimientos laterales del cuello. El diagnóstico y tratamiento del Síndrome de Eagle está basado en la sintomatología y el examen radiográfico del paciente, lo cual determinará el tratamiento quirúrgico o no quirúrgico. El Síndrome de Eagle es una patología compleja que requiere un conocimiento amplio de sus signos y síntomas, para establecer un correcto diagnóstico y posteriormente un adecuado tratamiento. Para ello, es necesario difundir la información sobre este síndrome entre los profesionales médico-odontológico y así brindar una atención adecuada a cada uno de los pacientes.