Loroch Anna, Qamar Sabih Nadeem, Jaffer Mehaab, Smillie Ian
Department of ENT, NHS Greater Glasgow and Clyde, Glasgow, GBR.
Department of ENT Surgery, University Hospital Monklands, Airdrie, GBR.
Cureus. 2022 Jan 27;14(1):e21666. doi: 10.7759/cureus.21666. eCollection 2022 Jan.
Eagle's syndrome is a rare cause of cervicofacial pain and is due to abnormalities in the stylohyoid process, stylohyoid ligament or lesser cornu of the hyoid bone. Generally, patients affected by Eagle's syndrome present with pain in the lateral or upper neck, angle of the mandible, submandibular space and throat (exacerbated by head movements and/or mastication); foreign body sensation; headache and referred otalgia. A 66-year old gentleman presented with a 36-month history of recurrent pain localising mainly to the right angle of the mandible and radiating to the submandibular triangle. No pathological changes were noted on multiple ultrasound scans. Flexible nasendoscopy revealed a right vocal cord palsy. Initially, the CT scan revealed an abnormality in the stylohyoid complex, and the patient was managed conservatively. Subsequent three-dimensional CT scan noted significant worsening of the abnormality in the stylohyoid complex. Due to progressive nature of the patient's symptoms and progression of stylohyoid complex calcification noted on imaging, the patient was listed for surgery. He underwent partial styloidectomy and vocal cord injection for cord paralysis secondary to impingement on the vagal nerve by the stylohyoid complex. The patient recovered well and denies any ongoing stylalgia. Various cases of Eagle's syndrome have been managed successfully in a conservative manner. However, the authors of this case report suggest that patients with Eagle's syndrome should be monitored closely. A delay in surgical intervention can lead to complications such as complete ossification of the stylohyoid complex and impingement on surrounding structures. This, in turn, increases intra-operative complexity.
伊格尔综合征是颈面部疼痛的罕见病因，由茎突舌骨肌、茎突舌骨韧带或舌骨小角异常所致。一般来说，伊格尔综合征患者表现为颈部外侧或上部、下颌角、下颌下间隙及咽喉疼痛（头部运动和/或咀嚼时加重）；异物感；头痛及牵涉性耳痛。一名66岁男性患者有36个月复发性疼痛病史，主要定位于右下颌角并放射至下颌下三角。多次超声扫描未发现病理改变。可弯曲鼻内镜检查显示右侧声带麻痹。最初，CT扫描显示茎突舌骨复合体异常，患者接受保守治疗。随后的三维CT扫描显示茎突舌骨复合体异常显著恶化。由于患者症状呈进行性发展且影像学检查发现茎突舌骨复合体钙化进展，该患者被安排手术。他接受了部分茎突切除术及声带注射，以治疗因茎突舌骨复合体压迫迷走神经导致的声带麻痹。患者恢复良好，否认有持续的茎突痛。多种伊格尔综合征病例已通过保守方法成功治疗。然而，本病例报告的作者建议，伊格尔综合征患者应密切监测。手术干预延迟可导致并发症，如茎突舌骨复合体完全骨化及对周围结构的压迫。这进而增加了手术复杂性。
