Pain in the Neck: Are We Potentially at Risk?

Abstract

Clinical symptoms of the patient with Eagle syndrome (ES) are usually very subtle and often confusing even for the most seasoned clinicians. This confusion may lead to a vast number of misdiagnoses. When an elongated styloid process becomes symptomatic, usually the symptoms are varied for each individual, due to the complex nature of the head and neck region. It is essential that a diagnosis of ES be included when evaluating many head and neck conditions. Some cases might require further extensive examination, since ES presents with various heterogeneous symptoms, making it extremely challenging to diagnose. Recently, a case was reported of a sudden death due to ES, a mechanical irritation of the carotid sinus initiated by an elongated styloid process that led to an acute cardiovascular failure. These types of incidences are rare, but very concerning. An elongated styloid process, found frequently in panoramic radiographs, may be a significant and coincidental finding that could possibly be related to many systemic conditions. Therefore, due to calcification of the styloid process, medical attention including a workup would be warranted. A digital panoramic radiograph, readily available in many dental offices, is sufficient to confirm a diagnosis of ES. In rare cases, surgical intervention may become necessary. A cone beam computed tomography (CBCT), which reconstructs a three-dimensional image, can accurately measure the length of the elongated styloid process and assess the severity of the condition. Clinicians, who examine and provide care for the patient with pain in the head and neck region, must become aware of this entity when suspected symptoms are present.




J Med Cases. 2017;8(8):237-240
doi: https://doi.org/10.14740/jmc2848w