Prevalence of elongation and calcification patterns of elongated styloid process in south India.

OBJECTIVE: Very few studies have been reported in the literature classifying the elongation and calcification patterns of styloid process. The present study was done to investigate the prevalence of elongation and calcification patterns of styloid process in patients attending a dental institution in south India. STUDY DESIGN: 600 digital panoramic radiographs of patients with dental problems were obtained from the outpatient department of the Dental institution. The apparent length of the styloid process was measured by a single experienced oral radiologist, with the help of the measuring tools on the accompanying software. The type of elongation and calcification patterns of each elongated styloid process was classified as per Langlai's classification with few modifications. Finally the data was subjected to statistical analysis. RESULTS: Out of 520 measurable styloid processes (260 panoramic radiographs), 154 styloid processes had length greater than 3cm. The mean average length of elongated styloid process was 3.67±0.62 cm. No significant association was obtained between age and length of styloid process. In present study, the type of elongation pattern has no effect on the calcification pattern. Our results suggested that Type I elongated styloid processes were most likely to be completely calcified (type D), but statistically not significant. CONCLUSION: Type I pattern of elongation was found to be more prevalent in elder age group and was completely calcified in most of the cases. Interestingly, only three patients (out of 260) showed symptomatic elongation of styloid process. A relatively high prevalence of type IV elongation pattern (9 /154) was obtained in the present study, when compared to type III styloid process. Further large scale imaging studies are required to evaluate the presence of type IV elongation pattern in various population groups. Key words:Eagle's syndrome, Elongated styloid process, Stylopharyngeous muscle, Tonsillectomy.

Multifocal Epithelial Hyperplasia of Oral Cavity Expressing HPV 16 Gene: A Rare Entity.

Focal epithelial hyperplasia is a rare contagious disease caused by human papilloma virus. Usually HPV involves either cutaneous or mucosal surfaces, whereas concomitant mucocutaneous involvement is extremely rare. We report such a unique case of multifocal epithelial hyperplasia involving multiple sites of oral cavity along with skin lesions in a 65-year-old female. We also discuss the probable multifactorial etiology and variable clinical presentations of the lesions, including evidence of HPV 16 expression, as detected by polymerase chain reaction. The present report illustrates the need for careful examination and prompt diagnosis of the disease, as it might be associated with high risk genotypes such as HPV 16 and 18.