Eagle syndrome: elongated stylohyoid-associated facial pain

Correspondence to Anand Goomany; anandg@doctors.org.uk Description A 47-year-old man with a history of recent root canal treatment on a lower left molar, presented to the Maxillofacial Surgery Department with a 6-month history of left-sided facial pain. A CT scan of the neck demonstrated an enlarged left styloid process with calcification of the stylohyoid ligament, characteristic of Eagle syndrome (figures 1 and 2). The length of the styloid process varies, however 30 mm is thought to be the upper limit of normal.2 Several theories for Eagle syndrome have been proposed: (1) surgical trauma or local chronic irritation causing reactive ossifying hyperplasia within the stylohyoid complex; (2) reactive metaplasia secondary to the healing response to trauma and (3) normal anatomical variance.3 Eagle syndrome may present with the classic features of facial/oropharyngeal pain exacerbated by head movement, globus sensation, dysphagia and otalgia.