[Three cases of Eagle's syndrome].

Recently microvascular decompression surgery has been performed for trigeminal neuralgia or glossopharyngeal neuralgia with remarkable success. In differential diagnosis of such neuralgia, a lot of atypical facial pain must be taken into consideration, one of which is so-called Eagle's syndrome. This syndrome is characterized by elongated styloid process or calcified stylohyoid ligament compressing the Vth and/or IXth cranial nerve. In the present paper we report three cases of Eagle's syndrome and discuss the mechanism, differential diagnosis and surgical treatment of the facial pain in this syndrome. The first case was a 40-year-old man. He complained of continuous dull pain on the right face. Sometimes he also suffered from radiating pain into the orbit and maxillary region. A-P and lateral projection of plain skull film showed elongated styloid process measuring about 4.5 cm in length. This process curved medially and was palpable in the tonsillar fossa. Above mentioned radiating pain was released by the injection of local anesthesic agent into the tonsillar fossa. From these findings, diagnosis of Eagle's syndrome was made. He was performed partial styloidectomy by transoral approach with complete relief of the facial pain. The second case was a 49-year-old woman. She complained of continuous or periodic pain that radiating from the right subauricular area to the right neck. Lateral view of plain skull film showed elongation of her right styloid process measuring about 4 cm in length. In the right tonsillar fossa, the elongated styloid process was palpable, compression of which induced radiating pain. By injection of anesthesic material into the right tonsillar fossa the pain disappeared temporarilly.(ABSTRACT TRUNCATED AT 250 WORDS)