Eagle syndrome
What is it?
Eagle syndrome is a rare condition commonly characterized but not limited to sudden, sharp nerve-like pain in the jaw bone and joint, back of the throat, and base of the tongue, triggered by swallowing, moving the jaw, or turning the neck. Since the brain to body's nerve connections pass through the neck, many seemingly random symptoms can be triggered by impingement or entanglement.
Additional names
This group contains additional names:
- Elongated styloid process syndrome
- Stylohyoid syndrome
- Styloid syndrome
- Styloid-stylohyoid syndrome
Signs & symptoms
Possible symptoms include:
* Sharp, shooting pain in the jaw, back of the throat, base of the tongue, ears, neck, and/or face
* Difficulty swallowing
* Sensation of having a foreign object in throat
* Pain from chewing, swallowing, turning the neck, or touching the back of the throat
* Ringing or buzzing in the ears
Classic eagle syndrome is present on only one side, however, rarely, it may be present on both sides.
In vascular Eagle syndrome, the elongated styloid process comes in contact with the internal carotid artery below the skull. In these cases, turning the head can cause compression of the artery or a tear inside the blood vessel, which restricts blood flow and can potentially lead to a transient ischemic attack (TIA) or stroke. Sometimes, compression of the internal jugular vein can also occur and might lead to increased intracranial pressure.
Diagnosis
Diagnosis is suspected when a patient presents with the symptoms of the classic form of "Eagle syndrome" e.g. unilateral neck pain, sore throat or tinnitus. Sometimes the tip of the styloid process is palpable in the back of the throat. The diagnosis of the vascular type is more difficult and requires an expert opinion. One should have a high level of suspicion when neurological symptoms occur upon head rotation. Symptoms tend to be worsened on bimanual palpation of the styloid through the tonsillar bed. They may be relieved by infiltration of lidocaine into the tonsillar bed. Because of the proximity of several large vascular structures in this area this procedure should not be considered to be risk free.
Imaging is important and is diagnostic. Visualizing the styloid process on a CT scan with 3D reconstruction is the suggested imaging technique. The enlarged styloid may be visible on an orthopantogram or a lateral soft tissue X ray of the neck.
Treatment
In both the classic and vascular form, the treatment is surgical. A partial styloidectomy is the preferred approach. Repair of a damaged carotid artery is essential in order to prevent further neurological complications. Regrowth of the stylohyoid process and relapse being a common occurrence is debatable.Medical management may include the use of pain and anti-inflammatory medications, antidepressants, and/or corticosteroids. The overall success rate for treatment (medical or surgical) is about 80%.
☝️ This is not a substitute for professional medical advice. Please consult with your physician before making any medical decision.
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