RESUMEN
Aims: The aim of the present study was to investigate the radiographic prevalence of elongation and calcification in styloid complex and its clinical significance and etiology in female patients attending Taibah University Dental Clinics (TUDC) in Al-Madinah, KSA. Study Design: Retrospective observational study. Place and Duration of Study: Oral Radiology Unit, Taibah University Dental clinics, Faculty of Dentistry, Al Madinah Al Monwarah, Saudi Arabia, between February 2015 and February 2016. Methodology: A total of 2114 archived digital panoramic radiographs of female patients attending TUDC with a mean age of 33.3 that ranges from (18-80 years) were examined for the presence of elongated styloid process or calcification of stylohyoid ligament. We excluded cropped or blurred panoramic radiograph. Results: The most frequent age for elongation was between 20-40 years. An overall prevalence of calcification and elongation in the styloid complex was 189 patients (11%) out of 1714. About 176 (10.3%) of them had elongated styloid process with complete calcification while 13 (0.7%) had fragmented calcification. Head or neck injury was the prevalent suspecting etiology in 31.3%, and pain with swallow was a clinical finding of participated patients in the questionnaire. Conclusion: It is critical that the dentist should be attentive to normal variation in the styloid complex to be able to detect any elongation or calcification which could be discovered incidentally in radiographic examination particularly panoramic radiograph. Panorama is an economical, easily accessible and useful diagnostic screening tool for an early detection of elongated styloid process with or without symptoms.
RESUMEN
Objectives: The aims of this study were to evaluate the length, morphology, and calcification patterns of the elongated stylohyoid process (ESP) on panoramic radiographs and to investigate the symptoms related to it. We then addressed the question: Is ESP a pathologic condition or a physiologic phenomenon? Materials and Methods: In this study, 207 stylohyoid complexes were evaluated based on length, radiographic appearance, and calcification pattern on panoramic radiographs. Similar to previous studies, we considered 30 mm as a threshold for elongation of the process. Complexes were classified into two groups based on length: ESP (greater than or equal to 30 mm) and normal (less than 30 mm). Clinical symptoms were evaluated by using a questionnaire and clinical examination. Data were analyzed by the Kolmogorov-Smilonov test, Mann-Whitney U test, and Spearman correlation. Results: The average length of the stylohyoid complex was 31.7 mm. The median was 30.0 mm and corresponded to the threshold for the ESP. The Spearman correlation between the length of the complex and age was 0.323 (P=0.0001). "Continuous" and "calcified outline" were the most frequent morphology and calcification pattern, respectively, for both groups. Clinical symptoms related to ESP were not detected. Conclusion: Classification of the stylohyoid complexes based on apparent length on panoramic radiographs in elongated and normal types appears to be incorrect. Considering that the radiographic appearance of the ESP and normal groups was similar and pathologic symptoms were not detected and that there was a relationship between age and length of the complex, elongation of this complex can be considered as a physiologic phenomenon.