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Eagle syndrome

Eagle syndrome is characterized by unilateral pain in the oropharynx, the side of the face, and the earlobe.

Although quite rare, this syndrome is well represented in the oral, ear, nose, and throat surgery literature. In the neurosurgical literature, on the other hand, there is little if any mention of Eagle syndrome 1).

It is caused by an elongated styloid process; resection of the elongated process eliminates the pain.

The styloid process can also cause compression of the cervical carotid arteries leading to the so-called carotid artery syndrome together with carotidynia or neurological symptoms due to flow reduction in these arteries 2).

Case series

Twenty-five subjects with ES and 25 controls were included in a retrospective study. Styloid process length, anterior-posterior styloid process angulation (Sagittal plane angle) (APA), medial-lateral styloid process angulation (Coronal plane angle) (MLA), tonsil-stiloid distance and carotid-stiloid distance were measured on CT and 3DCT images, and cranial and neck angiography was obtained, from a total of 580 images.

The styloid process lengths were 40.3 mm and 40.5 mm on the right and left sides in the ES group. The left MLA was lower in symptomatic (Median: 67.0 ᴏ ) than asymptomatic (Median: 72.6 ᴏ ) ES patients.

In ES patients with styloid process length above 3 cm, MLA (coronal plane angle) is important, and the symptoms are more intense when this angle is smaller 3).

Case reports


Slavin present a case of a woman who suffered from severe pain in the throat, the side of the face, and the ear. After the diagnosis of Eagle syndrome was made based on radiographic findings and was confirmed using a local anesthetic block, resection of the elongated styloid process was performed, resulting in complete and lasting pain relief. Eagle syndrome, which is caused by compression of the glossopharyngeal nerve as it passes the elongated styloid process, may be classified as an entrapment syndrome deserving of neurosurgical attention. The goal of this report is to familiarize neurosurgeons with Eagle syndrome and its diagnostic work up and treatment 4)

1) , 4)
Slavin KV. Eagle syndrome: entrapment of the glossopharyngeal nerve? Case report and review of the literature. J Neurosurg. 2002 Jul;97(1):216-8. PubMed PMID: 12134918.
Farhat HI, Elhammady MS, Ziayee H, Aziz-Sultan MA, Heros RC. Eagle syndrome as a cause of transient ischemic attacks. J Neurosurg. 2009 Jan;110(1):90-3. doi: 10.3171/2008.3.17435. PubMed PMID: 18821836.
Burulday V, Akgül MH, Bayar Muluk N, Yağdıran B, Inal M. The importance of medial-lateral styloid process angulation/Coronal plane angle in symptomatic Eagle Syndrome. Clin Anat. 2017 Feb 13. doi: 10.1002/ca.22842. [Epub ahead of print] PubMed PMID: 28192866.
eagle_syndrome.txt · Last modified: 2017/02/14 08:28 (external edit)