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Eagle Syndrome
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Eagle Syndrome

I have been diagnosed with Eagle syndrome (elongation of the styloid bone) after years of ear eye and dental pain.  Do you know if surgery which is my option for treatment is usually successful.
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Dear Wenpen,

Thank you for submitting your question.
I will answer your concerns to the best of my abilities, but please be informed that I am unable to offer a diagnosis based on your history and list of symptoms.
I am extremely limited in not having the opportunity to perform a full neurologic examination on you, nor am I able to review the pertinent imaging.
This is solely for educational purposes and should in no way be a substitute for a formal evaluation by a certified physician.

To be quite honest with you, I have never seen nor diagnosed a patient with Eagle syndrome.

Thus, I had to conduct my own research to answer your question.

As a benefit to both of us, please give me an opportunity to speak briefly on "Eagle syndrome."

Eagle syndrome is medically known as the elongation of the styloid process and stylohyoid ligament calcification. This typically occurs with aging, and often results in sharp, intermittent pain along the glossopharyngeal nerve that is located in the pharynx and at the base of the tongue.

The styloid process is a piece of bone that starts at the base of the skull and attaches to a number of muscles and ligaments that are connected to the throat and tongue. Elongation of the stolid process, as well as a calcification of the stylohyoid ligament, can result in Eagle Syndrome. The stylohyoid ligament is located between the styloid process and the hyoid bone, a bone in the front of the throat, to which a number of throat muscles are attached.

People with Eagle syndrome may experience a wide range of symptoms, including pain in both the throat and the ear, vertigo, voice alteration, cough, dizziness, sinusitis or bloodshot eyes. It may feel like something is stuck in one's throat, and swallowing may be difficult. It may also be painful to turn one's head. Pain during swallowing, opening the mouth or turning the head may also be experienced.

Treatment of Ernest syndrome, which is successful about 80 % of the time, includes a soft diet, use of an intra-oral splint, physiotherapy, medication and injections of local anesthetics at the insertion of the ligament.

There are reports that radiofrequency thermoneurolysis is effective in treating symptoms of Ernest syndrome. However, these studies lack scientific rigor and the claims of effectiveness have not been validated in clinical studies.

Surgical shortening has also been proposed as a  treatment to alleviate the pain based on the thought that the symptoms were caused by an elongated styloid process.
I was unable to find a study that provided numbers or statistics on the effectivenss of any of these surgical procedures.

To be honest, I think that the current literature makes a pretty strong case for assuming that surgery for Eagle syndrome has not proven to be superior over medical management, nor has it deemed to be even successful.

I recommend that you go the medical route prior to entertaining surgery -- that is, a soft diet, use of an intra-oral splint, physiotherapy, and injections of local anesthetics at the insertion of the ligament.

Hope this helps,
JKL, MD



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I just discussed my surgery experience in another forum, so I'll cut and paste it here.  Hope it's of some help.
I'm a 49 year old male.
I had surgery about 1.5 years ago to remove my elongated styloid process.  Had one good year, symptom free after that and then slowly pain returned in the same area.  However, I no longer have the foreign body sensation and I don't have much problem swallowing.  The pain is more like a muscle spasm.  A cortisone injection gave me 3 more months pain free.  Another cortisone injection produced no results.  I suspect that I'm experiencing problems with the stylohyoid ligament re: calcification or ossification and will have to look at further surgery with my surgeon in Victoria BC
I saw three specialists before him, none of whom recommended or was willing to do surgery.  
Basically I'm happy I went through with the surgery even though it didn't last.  It just amazes me how big a **** shoot the treatment of this condition is.
Even my current surgeon, an Ear, Nose & Throat specialist always says to me... "you know as much as I do".  
I hear talk of Prolotherapy (injecting irritants to provoke the bodies natural healing process) but not much concrete evidence.
I wish the best for all you Eagle's Syndrome sufferers.
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