Eagle’s syndrome
Overview
A group of symptoms caused by calcification of the stylohyoid ligament and an abnormally long styloid process. The styloid process is a bone at the base of the skull which is attached to muscles and ligaments connected to the throat and tongue. If this bone is too long then actions such as swallowing and turning the head can cause pain and discomfort. The cause of the condition is unknown but trauma and inflammation may be the cause in some cases.
Symptoms
* Pain on turning head * Pain on extending tongue * Voice changes * Cough * Sinusitis * Dizziness * Bloodshot eyes * Throat pain * Facial pain * Foreign body sensation in throat * Dysphagia * Disturbed sense of taste * Asymptomatic * Headache * Sensation of excessive salivation * Throat discomfort * Vertigo * Swallowing difficulty * Pain on opening mouth
Causes
* Acute or chronic otitis media * Impacted cerumen * Eustachian tube dysfunction –“Ocean roar” that may wax and wane with respiration * Dysfunctional hearing aid * Presbycusis (high pitch) * Idiopathic (low pitch) * Noise-induced hearing loss (high pitch) * Meniere's disease –Triad of tinnitus, hearing loss, and vertigo * Ototoxicity secondary to drugs –High pitch –May persist after medication (e.g., aminoglycosides) –May be dose-related (e.g., aspirin) * Trauma –Commonly associated with airbag, whiplash, barotrauma –May have ruptured tympanic membrane * TMJ syndrome –Nonpulsatile tinnitus (Costen's syndrome) –Associated jaw symptoms (e.g., pain, clicking) * Migraine headache * Vascular disease (e.g., atherosclerosis, diabetic vasculopathy, arteriovenous malformation, small vessel disease, hypertension) * Stroke + Otosclerosis –Associated with chronic otitis media or tympanic membrane trauma + Pseudotumor cerebri + Tumor –Glomus tympanicum or jugulare: Pulsatile tinnitus with hearing loss –Acoustic neuroma: Unilateral hearing loss and tinnitus, headache + Infections (e.g., meningitis, Lyme disease, rubella) + Less common etiologies (“zebras”) include thyroid disease, Paget's disease, myoclonus of palatal muscles, fetal insults (infections, toxins), sickle cell disease, osteogenesis imperfecta, neurosyphilis, symptomatic Chiari malformation, late onset congenital hearing loss, dissecting aneurysm, carotid cancer, and multiple sclerosis
Treatment
Surgery