Eagle’s syndrome: Modern systematic review and presentation of radiographic
cases
Liappis Evangelos, Venetis Athanasios, Vlachopanos Zois-Panagiotis, Impas Christos, Papadeli Chrysi
Department of Dentoalveolar Surgery, Implantology & Oral Radiology, Section of Oral – Maxillofacial Pathology,
Surgery & Radiology School of Dentistry, Aristotle University of Thessaloniki
DOI: 10.54936/haoms2427186
SUMMARY: Introduction: The styloid process is a bony structure of the base of the skull, which can undergo pathological structural changes. So, its elongation may possibly provoke Eagle’s syndrome, also known as stylohyoid syndrome, which is a head and neck pathological condition that rarely manifests with severely painful symptomatology.
Objective: The present literature review aims to deal with the understanding of the pathophysiology, as well as the investigation of the diagnostic and therapeutic facts regarding Eagle’s syndrome.
Materials – Methods: An extended research of modern literature through papers published in scientific journals has been conducted, deploying the databases PubMed and Google Scholar.
Results: Eagle’s syndrome is a rare pathological condition, whose prevalence is approximately 4% of general population. In the literature, several pathogenetic patterns have been reported and they are divided into acquired and idiopathic biochemical mechanisms. In order to diagnose the disease, one should take the painful symptoms referred by the patient into consideration, in conjunction with specific clinical tests. However, the final diagnosis is set after the radiological evaluation. Eagle’s syndrome manifests with non-specific symptomatology, thus it should be differentiated from other diseases and conditions of the head and neck anatomical area. Regarding the therapy of the syndrome, a vast range of conservative choices is available nowadays, mainly basedon drugs, while at the same time there are surgical techniques with comparatively better long-term outcome.
Conclusions: There is an expressively increased interest, regarding the diagnosis and the therapeutics of Eagle’s syndrome. Modern medical sciences attempt to gradually advance the diagnostic methodology and constantly improve the therapeutic choices of this disease. The ultimate purpose is the more effective management of the patients and the enhancement of their life quality.
KEY WORDS: Eagle’s syndrome, elongated styloid process, stylohyoid syndrome
REFERENCES
1. Fusco DJ, Asteraki S, Spetzler RF. Eagle’s syndrome: embryology, anatomy, and clinical management. Acta Neurochir (Wien). 2012;154(7):1119-26.
2. Czako L, Simko K, Thurzo A, Galis B, Varga I. The Syndrome of Elongated Styloid Process, the Eagle’s Syndrome – From Anatomical, Evolutionary and Embryological Backgrounds to 3D Printing and Personalized Surgery Planning. Report of Five Cases. Medicina (Kaunas). 2020;56(9):458.
3. Bokhari MR, Graham C, Mohseni M. Eagle Syndrome. 2023. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 28613540.
4. Bagga MB, Kumar CA, Yeluri G. Clinicoradiologic evaluation of styloid process calcification. Imaging Sci Dent. 2012;42(3):155-61.
5. Chabikuli NJ, Noffke CEE. Styloid process elongation according to age and gender: a radiological study. S Afr Dent J. 2016;71(10):470-473.
6. Saccomanno S, Quinzi V, D’Andrea N, Albani A, Coceani Paskay L, Marzo G. Traumatic Events and Eagle Syndrome: Is There Any Correlation? A Systematic Review. Healthcare. 2021;9(7):825.
7. de Barros JF, Rodrigues MV, Barroso LA, Amado IC. Eagle Syndrome: an underdiagnosed cause of orofacial pain. BMJ Case Rep. 2021;14(1):e238161.
8. Saccomanno S, Greco F, DE Corso E, Lucidi D, Deli R, D’Addona A et al. Eagle’s Syndrome, from clinical presentation to diagnosis and surgical treatment: a case report. Acta Otorhinolaryngol Ital. 2018;38(2):166-169.
9. Egierska D, Perszke M, Kurianowicz I. Eagle’s syndrome. Pol Merkur Lekarski. 2021;49(294):458 460.
10. Wolińska I, Jaźwiec P, Pawłowska M, Gać P, Poręba R, Poręba M. Eagle’s Syndrome as a Cause of Discomfort and the Subjective Presence of a Foreign Body in the Throat. Diagnostics (Basel). 2021;11(10):1832.
11. Gokce C, Sisman Y, Sipahioglu M. Styloid Process Elongation or Eagle’s Syndrome: Is There Any Role for Ectopic Calcification? Eur J Dent. 2008;2(3):224-8.
12. Natsis K, Repousi E, Noussios G, Papathanasiou E, Apostolidis S, Piagkou M. The styloid process in a Greek population: an anatomical study with clinical implications. Anat Sci Int. 2014;90(2):67-74.
13. Li S, Blatt N, Jacob J, Gupta N, Kumar Y, Smith S. Provoked Eagle syndrome after dental procedure: A review of the literature. Neuroradiol J. 2018;31(4):426-429.
14. Langlais RP, Miles DA, Van Dis ML. Elongated and mineralized stylohyoid ligament complex: a proposed classification and report of a case of Eagle’s syndrome. Oral Surg Oral Med Oral Pathol. 1986;61(5):527-32.
15. Baldino G, Di Girolamo C, De Blasis G, Gori A. Eagle Syndrome and Internal Carotid Artery Dissection: Description of Five Cases Treated in Two Italian Institutions and Review of the Literature. Ann Vasc Surg. 2020;67(565):e17–e24.
16. Soldati AB, Miguelote C, Quero C, Pereira R, Santos R, Soares C. Eagle’s syndrome. Arq Neuro-Psiquiatr. 2013;71(4):265-6.
17. Czajka M, Szuta M, Zapała J, Janecka I. Assessment of surgical treatment of Eagle’s syndrome. Otolaryngol Pol. 2019;73(5):18-24.
18. Thoenissen P, Bittermann G, Schmelzeisen R, Oshima T, Fretwurst T. Eagle’s syndrome – A non-perceived differential diagnosis of temporomandibular disorder. Int J Surg Case Rep. 2015;15:123-6.
19. Steinmann EP. Styloid Syndrome in Absence of an Elongated Process. Acta Otolaryngol. 1968;66(4):347-56.
20. Gupta M, Kumar Y, Vig H, Rizvi A. Classic Eagle’s Syndrome: Styloidectomy via the Transcervical Approach. BMJ Case Rep.2021;14(8):e244634.
21. Dabrowski DS, Ghali GE, Cotelingam JD. Bilateral Eagle Syndrome. Ear Nose Throat J. 2022;101(10):645-646.
22. Piagkou M, Anagnostopoulou S, Kouladouros K, Piagkos G. Eagle’s syndrome: a review of the literature. Clin Anat. 2009;22(5):545-58.
23. Yasmeenahamed S, Laliytha BK, Sivaraman S, Ambiga P, Dineshshankar J, Sudhaa M. Eagle’s syndrome – Masquerading as ear pain: Review of literature. J Pharm Bioallied Sci. 2015;7(Suppl 2):S372-3.
24. Yavuz H, Caylakli F, Yildirim T, Ozluoglu LN. Angulation of the styloid process in Eagle’s syndrome. Eur Arch Otorhinolaryngol. 2008;265(11):1393-6.
25. Magat G, Ozcan S. Evaluation of styloid process morphology and calcification types in both genders with different ages and dental status. J Istanb Univ Fac Dent. 2017;51(2):29-36.
26. Swain BP, Vidhya S, Kumar S. Eagle’s Syndrome Managed Successfully by Pulsed Radiofrequency Treatment. Cureus. 2020;12(9):e10574.
27. Yıldırımyan N, Daloğlu M, Sindel A, Altay MA. From diagnosis to treatment: eagle syndrome. J Otolaryngol ENT Res. 2017;8(3):456-458.
28. Uludağ İF, Öcek L, Zorlu Y, Uludağ B. Eagle syndrome: case report. Agri. 2013;25(2):87-9.
29. Bahgat M, Bahgat Y, Bahgat A. Eagle’s syndrome, a rare cause of neck pain. BMJ Case Rep. 2012;2012:bcr2012006278.
30. Goomany A, Shayah A, Adams B, Coatesworth A. Eagle syndrome: elongated stylohyoid – associated facial pain. BMJ Case Rep. 2020;13(3):e234024.
31. Thot B, Revel S, Mohandas R, Rao AV, Kumar A. Eagle’ syndrome. Anatomy of the styloid process. Indian J Dental Res. 2000;11(2):65-70.
32. Jeyaraj P. Histopathological Analysis of Elongated Styloid Processes: A New Light on Etiopathogenesis of Eagle’s Syndrome. Indian J Otolaryngol Head Neck Surg. 2022;74(Suppl3):4510-20.
33. Dey A, Mukherji S. Eagle’s Syndrome: A Diagnostic Challenge and Surgical Dilemma. J Maxillofac Oral Surg. 2022;21(2):692-6.
34. Pigache P, Fontaine C, Ferri J, Raoul G. Transcervical styloidectomy in Eagle’s syndrome. Eur Ann Otorhinolaryngol Head Neck Dis. 2018;135(6):433-436.
35. Nunes F, Fernandes MJ, Silva M, Porteiro B, Dutschmann R. Eagle’s Syndrome Presenting as Peripheral Facial Palsy. Cureus. 2022;14(2):e22499.
36. Westbrook AM, Kabbaz VJ, Showalter CR. Eagle’s syndrome, elongated styloid process and new evidence for pre-manipulative precautions for potential cervical arterial dysfunction. Musculoskelet Sci Pract. 2020;50:102219.
37. Badhey A, Jategaonkar A, Anglin Kovacs AJ, Kadakia S, De Deyn PP, Ducic Y et al. Eagle syndrome: A comprehensive review. Clin Neurol Neurosurg. 2017;159:34-38.
38. Cohn J, Scharf J. Eagle Syndrome. J Osteopath Med. 2018;118(9): 629-629.
39. Ortiz Sánchez A, Cervilla Sáez de Tejada E, López Peña C, Soler Góngora M, Barrientos Delgado A. Eagle’s syndromeas a cause of oropharyngeal dysphagia. Rev Esp Enferm Dig. 2022. doi: 10.17235/reed.2022.9295/2022.
40. Zamboni P, Scerrati A, Menegatti E, Galeotti R, Lapparelli M, Traina L et al. The eagle jugular syndrome. BMC Neurol. 2019;19(1):333.
41. Gallaway E, Bayoumi S, Hammond D, Halsnad M. Case report: an atypical presentation of Eagle syndrome. J Surg Case Rep. 2017;2017(8):1-3.
42. Casale M, Rinaldi V, Quattrocchi C, Bressi F, Vincenzi B, Santini D et al. Atypical chronic head and neck pain: don’t forget Eagle’s syndrome. Eur Rev Med Pharmacol Sci. 2008;12(2):131-3.
43. Gelabert-González M, García-Allut A. Síndrome de Eagle. Una causa poco frecuente de cervicalgia [Eagle syndrome. An unusual cause of neck pain]. Neurocirugia (Astur). 2008;19(3):254-6.
44. Zinnuroglu M, Ural A, Günendi Z, Meray J, Köybaşoğlu A. Is there a relationship between Eagle Syndrome and cervicofacial painful soft tissue rheumatisms? Laryngoscope. 2008;118(9):1569-73.
45. Tijanić M, Burić N, Burić K. The Use of Cone Beam CT(CBCT) in Differentiation of True from Mimicking Eagle’s Syndrome. Int J Environ Res Public Health. 2020;17(16):5654.
46. Hassen IB, Daghfous MH. Eagle syndrome imaging: a case report. J Otolaryngol ENT Res. 2018;10(5):278-279.
47. Arora V, Shetti A, Keluskar V. Eagle syndrome: A review of current diagnostic criteria and evaluation strategies. J Indian Acad Oral Med Radiol. 2008;20(1):1-5.
48. Başekim CC, Mutlu H, Güngör A, Silit E, Pekkafali Z, Kutlay M et al. Evaluation of styloid process by three-dimensional computed tomography. Eur Radiol. 2005;15(1):134-9.
49. Salamone FN, Falciglia M, Steward DL. Eagle’s syndrome reconsidered as a cervical manifestation of heterotopic ossification: woman presenting with a neck mass. Otolaryngol Head Neck Surg. 2004;130(4):501-3.
50. Prasad KC, Kamath MP, Reddy KJ, Raju K, Agarwal S. Elongated styloid process (Eagle’s syndrome): a clinical study. J Oral Maxillofac Surg. 2002;60(2):171-5.
51. Murthy PS, Hazarika P, Mathai M, Kumar A, Kamath MP. Elongated styloid process: an overview. Int J Oral Maxillofac Surg. 1990;19(4):230-1.
52. van der Westhuijzen AJ, van der Merwe J, Grotepass FW. Eagle’s syndrome: lesser cornu amputation: an alternative surgical solution? Int J Oral Maxillofac Surg. 1999;28(5):335-7.
53. de Souza Carvalho AC, Magro Filho O, Garcia IR Jr, de Holanda ME, de Menezes JM Jr. Intraoral approach for surgical treatment of Eagle syndrome. Br J Oral Maxillofac Surg. 2009;47(2):153-4.
54. Kumar PS, Singh DK, Gupta SK, Raina S, Prasad BK. Of Eagle’s Syndrome and Finding Some Clarity on Its Management. Indian J Otolaryngol Head Neck Surg. 2022;74(Suppl 2):2184-2189.
55. de Andrade KM, Rodrigues CA, Watanabe PC, Mazzetto MO. Styloid process elongation and calcification in subjects with tmd: clinical and radiographic aspects. Braz Dent J. 2012;23(4):443-450.
Department of Dentoalveolar Surgery, Implantology & Oral Radiology, Section of Oral – Maxillofacial Pathology,
Surgery & Radiology School of Dentistry, Aristotle University of Thessaloniki
DOI: 10.54936/haoms2427186
SUMMARY: Introduction: The styloid process is a bony structure of the base of the skull, which can undergo pathological structural changes. So, its elongation may possibly provoke Eagle’s syndrome, also known as stylohyoid syndrome, which is a head and neck pathological condition that rarely manifests with severely painful symptomatology.
Objective: The present literature review aims to deal with the understanding of the pathophysiology, as well as the investigation of the diagnostic and therapeutic facts regarding Eagle’s syndrome.
Materials – Methods: An extended research of modern literature through papers published in scientific journals has been conducted, deploying the databases PubMed and Google Scholar.
Results: Eagle’s syndrome is a rare pathological condition, whose prevalence is approximately 4% of general population. In the literature, several pathogenetic patterns have been reported and they are divided into acquired and idiopathic biochemical mechanisms. In order to diagnose the disease, one should take the painful symptoms referred by the patient into consideration, in conjunction with specific clinical tests. However, the final diagnosis is set after the radiological evaluation. Eagle’s syndrome manifests with non-specific symptomatology, thus it should be differentiated from other diseases and conditions of the head and neck anatomical area. Regarding the therapy of the syndrome, a vast range of conservative choices is available nowadays, mainly basedon drugs, while at the same time there are surgical techniques with comparatively better long-term outcome.
Conclusions: There is an expressively increased interest, regarding the diagnosis and the therapeutics of Eagle’s syndrome. Modern medical sciences attempt to gradually advance the diagnostic methodology and constantly improve the therapeutic choices of this disease. The ultimate purpose is the more effective management of the patients and the enhancement of their life quality.
KEY WORDS: Eagle’s syndrome, elongated styloid process, stylohyoid syndrome
REFERENCES
1. Fusco DJ, Asteraki S, Spetzler RF. Eagle’s syndrome: embryology, anatomy, and clinical management. Acta Neurochir (Wien). 2012;154(7):1119-26.
2. Czako L, Simko K, Thurzo A, Galis B, Varga I. The Syndrome of Elongated Styloid Process, the Eagle’s Syndrome – From Anatomical, Evolutionary and Embryological Backgrounds to 3D Printing and Personalized Surgery Planning. Report of Five Cases. Medicina (Kaunas). 2020;56(9):458.
3. Bokhari MR, Graham C, Mohseni M. Eagle Syndrome. 2023. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 28613540.
4. Bagga MB, Kumar CA, Yeluri G. Clinicoradiologic evaluation of styloid process calcification. Imaging Sci Dent. 2012;42(3):155-61.
5. Chabikuli NJ, Noffke CEE. Styloid process elongation according to age and gender: a radiological study. S Afr Dent J. 2016;71(10):470-473.
6. Saccomanno S, Quinzi V, D’Andrea N, Albani A, Coceani Paskay L, Marzo G. Traumatic Events and Eagle Syndrome: Is There Any Correlation? A Systematic Review. Healthcare. 2021;9(7):825.
7. de Barros JF, Rodrigues MV, Barroso LA, Amado IC. Eagle Syndrome: an underdiagnosed cause of orofacial pain. BMJ Case Rep. 2021;14(1):e238161.
8. Saccomanno S, Greco F, DE Corso E, Lucidi D, Deli R, D’Addona A et al. Eagle’s Syndrome, from clinical presentation to diagnosis and surgical treatment: a case report. Acta Otorhinolaryngol Ital. 2018;38(2):166-169.
9. Egierska D, Perszke M, Kurianowicz I. Eagle’s syndrome. Pol Merkur Lekarski. 2021;49(294):458 460.
10. Wolińska I, Jaźwiec P, Pawłowska M, Gać P, Poręba R, Poręba M. Eagle’s Syndrome as a Cause of Discomfort and the Subjective Presence of a Foreign Body in the Throat. Diagnostics (Basel). 2021;11(10):1832.
11. Gokce C, Sisman Y, Sipahioglu M. Styloid Process Elongation or Eagle’s Syndrome: Is There Any Role for Ectopic Calcification? Eur J Dent. 2008;2(3):224-8.
12. Natsis K, Repousi E, Noussios G, Papathanasiou E, Apostolidis S, Piagkou M. The styloid process in a Greek population: an anatomical study with clinical implications. Anat Sci Int. 2014;90(2):67-74.
13. Li S, Blatt N, Jacob J, Gupta N, Kumar Y, Smith S. Provoked Eagle syndrome after dental procedure: A review of the literature. Neuroradiol J. 2018;31(4):426-429.
14. Langlais RP, Miles DA, Van Dis ML. Elongated and mineralized stylohyoid ligament complex: a proposed classification and report of a case of Eagle’s syndrome. Oral Surg Oral Med Oral Pathol. 1986;61(5):527-32.
15. Baldino G, Di Girolamo C, De Blasis G, Gori A. Eagle Syndrome and Internal Carotid Artery Dissection: Description of Five Cases Treated in Two Italian Institutions and Review of the Literature. Ann Vasc Surg. 2020;67(565):e17–e24.
16. Soldati AB, Miguelote C, Quero C, Pereira R, Santos R, Soares C. Eagle’s syndrome. Arq Neuro-Psiquiatr. 2013;71(4):265-6.
17. Czajka M, Szuta M, Zapała J, Janecka I. Assessment of surgical treatment of Eagle’s syndrome. Otolaryngol Pol. 2019;73(5):18-24.
18. Thoenissen P, Bittermann G, Schmelzeisen R, Oshima T, Fretwurst T. Eagle’s syndrome – A non-perceived differential diagnosis of temporomandibular disorder. Int J Surg Case Rep. 2015;15:123-6.
19. Steinmann EP. Styloid Syndrome in Absence of an Elongated Process. Acta Otolaryngol. 1968;66(4):347-56.
20. Gupta M, Kumar Y, Vig H, Rizvi A. Classic Eagle’s Syndrome: Styloidectomy via the Transcervical Approach. BMJ Case Rep.2021;14(8):e244634.
21. Dabrowski DS, Ghali GE, Cotelingam JD. Bilateral Eagle Syndrome. Ear Nose Throat J. 2022;101(10):645-646.
22. Piagkou M, Anagnostopoulou S, Kouladouros K, Piagkos G. Eagle’s syndrome: a review of the literature. Clin Anat. 2009;22(5):545-58.
23. Yasmeenahamed S, Laliytha BK, Sivaraman S, Ambiga P, Dineshshankar J, Sudhaa M. Eagle’s syndrome – Masquerading as ear pain: Review of literature. J Pharm Bioallied Sci. 2015;7(Suppl 2):S372-3.
24. Yavuz H, Caylakli F, Yildirim T, Ozluoglu LN. Angulation of the styloid process in Eagle’s syndrome. Eur Arch Otorhinolaryngol. 2008;265(11):1393-6.
25. Magat G, Ozcan S. Evaluation of styloid process morphology and calcification types in both genders with different ages and dental status. J Istanb Univ Fac Dent. 2017;51(2):29-36.
26. Swain BP, Vidhya S, Kumar S. Eagle’s Syndrome Managed Successfully by Pulsed Radiofrequency Treatment. Cureus. 2020;12(9):e10574.
27. Yıldırımyan N, Daloğlu M, Sindel A, Altay MA. From diagnosis to treatment: eagle syndrome. J Otolaryngol ENT Res. 2017;8(3):456-458.
28. Uludağ İF, Öcek L, Zorlu Y, Uludağ B. Eagle syndrome: case report. Agri. 2013;25(2):87-9.
29. Bahgat M, Bahgat Y, Bahgat A. Eagle’s syndrome, a rare cause of neck pain. BMJ Case Rep. 2012;2012:bcr2012006278.
30. Goomany A, Shayah A, Adams B, Coatesworth A. Eagle syndrome: elongated stylohyoid – associated facial pain. BMJ Case Rep. 2020;13(3):e234024.
31. Thot B, Revel S, Mohandas R, Rao AV, Kumar A. Eagle’ syndrome. Anatomy of the styloid process. Indian J Dental Res. 2000;11(2):65-70.
32. Jeyaraj P. Histopathological Analysis of Elongated Styloid Processes: A New Light on Etiopathogenesis of Eagle’s Syndrome. Indian J Otolaryngol Head Neck Surg. 2022;74(Suppl3):4510-20.
33. Dey A, Mukherji S. Eagle’s Syndrome: A Diagnostic Challenge and Surgical Dilemma. J Maxillofac Oral Surg. 2022;21(2):692-6.
34. Pigache P, Fontaine C, Ferri J, Raoul G. Transcervical styloidectomy in Eagle’s syndrome. Eur Ann Otorhinolaryngol Head Neck Dis. 2018;135(6):433-436.
35. Nunes F, Fernandes MJ, Silva M, Porteiro B, Dutschmann R. Eagle’s Syndrome Presenting as Peripheral Facial Palsy. Cureus. 2022;14(2):e22499.
36. Westbrook AM, Kabbaz VJ, Showalter CR. Eagle’s syndrome, elongated styloid process and new evidence for pre-manipulative precautions for potential cervical arterial dysfunction. Musculoskelet Sci Pract. 2020;50:102219.
37. Badhey A, Jategaonkar A, Anglin Kovacs AJ, Kadakia S, De Deyn PP, Ducic Y et al. Eagle syndrome: A comprehensive review. Clin Neurol Neurosurg. 2017;159:34-38.
38. Cohn J, Scharf J. Eagle Syndrome. J Osteopath Med. 2018;118(9): 629-629.
39. Ortiz Sánchez A, Cervilla Sáez de Tejada E, López Peña C, Soler Góngora M, Barrientos Delgado A. Eagle’s syndromeas a cause of oropharyngeal dysphagia. Rev Esp Enferm Dig. 2022. doi: 10.17235/reed.2022.9295/2022.
40. Zamboni P, Scerrati A, Menegatti E, Galeotti R, Lapparelli M, Traina L et al. The eagle jugular syndrome. BMC Neurol. 2019;19(1):333.
41. Gallaway E, Bayoumi S, Hammond D, Halsnad M. Case report: an atypical presentation of Eagle syndrome. J Surg Case Rep. 2017;2017(8):1-3.
42. Casale M, Rinaldi V, Quattrocchi C, Bressi F, Vincenzi B, Santini D et al. Atypical chronic head and neck pain: don’t forget Eagle’s syndrome. Eur Rev Med Pharmacol Sci. 2008;12(2):131-3.
43. Gelabert-González M, García-Allut A. Síndrome de Eagle. Una causa poco frecuente de cervicalgia [Eagle syndrome. An unusual cause of neck pain]. Neurocirugia (Astur). 2008;19(3):254-6.
44. Zinnuroglu M, Ural A, Günendi Z, Meray J, Köybaşoğlu A. Is there a relationship between Eagle Syndrome and cervicofacial painful soft tissue rheumatisms? Laryngoscope. 2008;118(9):1569-73.
45. Tijanić M, Burić N, Burić K. The Use of Cone Beam CT(CBCT) in Differentiation of True from Mimicking Eagle’s Syndrome. Int J Environ Res Public Health. 2020;17(16):5654.
46. Hassen IB, Daghfous MH. Eagle syndrome imaging: a case report. J Otolaryngol ENT Res. 2018;10(5):278-279.
47. Arora V, Shetti A, Keluskar V. Eagle syndrome: A review of current diagnostic criteria and evaluation strategies. J Indian Acad Oral Med Radiol. 2008;20(1):1-5.
48. Başekim CC, Mutlu H, Güngör A, Silit E, Pekkafali Z, Kutlay M et al. Evaluation of styloid process by three-dimensional computed tomography. Eur Radiol. 2005;15(1):134-9.
49. Salamone FN, Falciglia M, Steward DL. Eagle’s syndrome reconsidered as a cervical manifestation of heterotopic ossification: woman presenting with a neck mass. Otolaryngol Head Neck Surg. 2004;130(4):501-3.
50. Prasad KC, Kamath MP, Reddy KJ, Raju K, Agarwal S. Elongated styloid process (Eagle’s syndrome): a clinical study. J Oral Maxillofac Surg. 2002;60(2):171-5.
51. Murthy PS, Hazarika P, Mathai M, Kumar A, Kamath MP. Elongated styloid process: an overview. Int J Oral Maxillofac Surg. 1990;19(4):230-1.
52. van der Westhuijzen AJ, van der Merwe J, Grotepass FW. Eagle’s syndrome: lesser cornu amputation: an alternative surgical solution? Int J Oral Maxillofac Surg. 1999;28(5):335-7.
53. de Souza Carvalho AC, Magro Filho O, Garcia IR Jr, de Holanda ME, de Menezes JM Jr. Intraoral approach for surgical treatment of Eagle syndrome. Br J Oral Maxillofac Surg. 2009;47(2):153-4.
54. Kumar PS, Singh DK, Gupta SK, Raina S, Prasad BK. Of Eagle’s Syndrome and Finding Some Clarity on Its Management. Indian J Otolaryngol Head Neck Surg. 2022;74(Suppl 2):2184-2189.
55. de Andrade KM, Rodrigues CA, Watanabe PC, Mazzetto MO. Styloid process elongation and calcification in subjects with tmd: clinical and radiographic aspects. Braz Dent J. 2012;23(4):443-450.
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