A RARE CASE OF LATE DIAGNOSIS OF ELONGATED STYLOID PROCESS SYNDROME

Abstract

Background: Eagle's syndrome comes from the name of the American otolaryngologist -- Watt Weems Eagle, who in 1937 was the first to distinguish a separate disease entity for symptoms associated with excessive elongation of the styloid process of the temporal bone. Case report: A 42-year old patient was admitted to the Department of Otolaryngology, Laryngological Oncology, Audiology and Phoniatrics in November 2018, in a planned mode, with persistent throat pain radiating to the right ear, right side head pain, tongue numbness and hoarseness. Symptoms of variable severity maintained for about 9 years, which is why the patient underwent bilateral tonsillectomy in October 2016. Due to persistent hoarseness, the patient was also qualified for micro-direct laryngoscopy with the removal of vocal cord nodules, the procedure was performed in March 2017. Despite the surgical treatment, the pain persisted. On the basis of the medical history, clinical observation, after analyzing the results of the tests with particular consideration of the neck CT scan with 3D reconstruction, the patient was diagnosed with right-sided Eagle's syndrome. The patient was qualified for surgery under general endotracheal anesthesia. In November 2018 partial resection of the right elongated styloid process was performed using an intraoral approach. After wound healing the patient reported complete pain relief. Conclusions: The elongated styloid process syndrome is most frequently a diagnosis of exclusion. Lack of proper diagnosis often delays significantly the implementation of proper management and thus exposes patients to long-term struggle with pain. If non-specific throat pain persists, the Eagle's syndrome should always be considered, which can be treated effectively.