Kumar Prem Shankar, Singh D K, Gupta Salil Kumar, Raina Sheetal, Prasad B K
Department of ENT & HNS, Command Hospital (Eastern Command), Kolkata, West Bengal 700027 India.
Indian J Otolaryngol Head Neck Surg. 2022 Oct;74(Suppl 2):2184-2189. doi: 10.1007/s12070-020-02079-2. Epub 2020 Aug 25.
Eagle's Syndrome is a much discussed yet controversial and debatable diagnosis of exclusion which is treated by many specialities with often unsatisfactory results. Due to entrapment/impingement on surrounding neurovascular structures by elongated styloid process patient may present with multitude of symptoms. Treatment is controversial and opinions are divided on choice of conservative and surgical management. Aim was to study outcomes of conservative and surgical modalities of treatment of Eagle's Syndrome and bring some clarity on management, what to offer, to whom and when. This prospective observational descriptive study included 15 patients of Eagle's Syndrome, 7 were treated with conservative method and 8 underwent resection of styloid process with intraoral approach. With objectives in mind to study efficacy of both management modalities, pain visual analogue scale (VAS) scores were recorded pre-intervention, post-intervention and during follow up on 1, 3 and 6 months and compared. Conservative management resulted in up to 70% reduction in pain VAS scores till 3 months of therapy (mean pre-intervention score being 3.71, 3 months-1, 6 months-1.29), while surgical modality resulted in nearly 99% reduction in mean pain VAS scores up to 3 months and even improved after 6 months (mean pre-intervention score being 6.75, 3 months-0.5, 6 months-0.13). With this we can conclude that conservative management provide satisfactory short-term (up to 3 months) results but recurrences are known, while surgical resection of elongated styloid process gives better long-term results (6 months and beyond).
鹰综合征是一种备受讨论但存在争议且有待论证的排除性诊断，许多专科都对其进行治疗，但其结果往往不尽人意。由于过长的茎突压迫/挤压周围神经血管结构，患者可能会出现多种症状。治疗存在争议，对于保守治疗和手术治疗的选择，各方观点不一。本研究旨在探讨鹰综合征保守治疗和手术治疗的效果，为治疗管理提供一些明确的方向，即提供何种治疗、针对何人以及何时进行治疗。这项前瞻性观察性描述性研究纳入了15例鹰综合征患者，其中7例采用保守治疗方法，8例采用经口入路切除茎突。为了研究两种治疗方式的疗效，在干预前、干预后以及随访的1个月、3个月和6个月记录疼痛视觉模拟量表（VAS）评分并进行比较。保守治疗在治疗3个月内使疼痛VAS评分降低了70%（干预前平均评分为3.71，3个月时为1，6个月时为1.29），而手术治疗在3个月内使平均疼痛VAS评分降低了近99%，6个月后甚至有所改善（干预前平均评分为6.75，3个月时为0.5，6个月时为0.13）。由此我们可以得出结论，保守治疗能提供令人满意的短期（长达3个月）效果，但复发情况较为常见，而手术切除过长的茎突能带来更好的长期效果（6个月及以后）。
