European Journal of Biomedical and Pharmaceutical Sciences

BILATERAL EAGLE SYNDROME PRESENTING WITH CERVICO-FACIAL PAIN: A RARE CASE REPORT

*Dr. Amit Sinha, Dr. Rumit Jha, Dr. Tek Nath Yogi

ABSTRACT

Background: Eagle syndrome is a rare condition caused by elongation of the styloid process or calcification of the stylohyoid ligament, leading to irritation or compression of adjacent neurovascular structures. It has two variants: the classic type and the stylocarotid artery syndrome, a vascular subtype where carotid artery compression or irritation of the sympathetic plexus results in neurological and vascular symptoms. Case Presentation: An 18-year-old male presented with a three-month history of dull, persistent pain and mild swelling over the left mandibular angle, worsened by mastication and wide mouth opening. Clinical examination showed localized tenderness without infection or lymphadenopathy. Orthopantomogram revealed bilateral elongated styloid processes. 3D-CT confirmed elongation measuring 6.5 cm on the right and 7.6 cm on the left, with segmented calcification. The left styloid process was notably close to neurovascular structures, correlating with unilateral symptoms. A transoral styloidectomy was performed under general anesthesia. The patient had an uneventful recovery and was symptom-free at the 3-month follow-up. Discussion: Clinical and imaging findings were consistent with stylocarotid-type Eagle syndrome. 3D-CT played a pivotal role in diagnosis and surgical planning. Transoral styloidectomy, though cosmetically favorable, requires precision due to limited access and proximity to neurovascular structures. Conclusion: Eagle syndrome should be considered in patients with unexplained cervicofacial pain. Timely diagnosis and appropriate surgical management can lead to excellent outcomes.

Keywords: Eagle syndrome, Elongated styloid process, Stylocarotid artery syndrome, 3D CT, Transoral styloidectomy.