经颌下径路治疗茎突综合征

报告30例(35侧)茎突综合征经颌下径路茎突截短术。其中茎突舌骨韧带骨化2例,茎突骨折1例。术前被误诊为牙痛而多次拔牙1例,X 线照片漏诊1例。经颌下径路术前茎突长3～7.5cm,平均右4.13cm,左4.38cm;手术截除平均长度右2.13cm,左2.26cm;术后存留平均长度右2.0cm,左2.12cm。术后经2月至6年(平均2年)随访,显效65.7%(23/35),好转28.6%(10/35),无效5.7%(2/35)。经咽径路茎突截短3例,其中1例术后发生颈深部出血和血肿。认为:经颌下径路茎突截短具有简便、安全。较咽径路更易暴露和截短,可作为茎突截短手术的首选;在临床上注意不要忽略茎突综合征的诊断,同时又要注意对茎突过长者要排除精神性咽痛的可能,以避免误行茎突截短术。     

茎突综合征72例分析

目的:探讨茎突综合征的正确诊断方法。方法:对疑有下颌角区异物感、咽部疼痛感、牵拉感、扁桃体术后伤口未愈合感等患者行茎突CT扫描及CT三维重建,确诊为茎突过长263例,其中72例行扁桃体切除加茎突截短术(59例行茎突截短术,13例行梳理术)。结果:术后随访,72例患者术前症状全部消失。结论:CT扫描及三维重建对诊断茎突过长综合征准确、可靠。     

茎突过长的CT诊断

茎突综合征是指茎突过长或舌骨韧带骨化引起的临床症状,有咽喉痛、吞咽痛、咽喉异物感、颈部转头不适或有耳痛、肩背疼痛等综合症状.以往靠X线摄片作为辅助检查诊断.但因投照模糊不清,茎突难以辨认.应用CT扫描,茎突显示非常清晰.现报告如下.     

茎突综合症25例临床分析

目的总结分析茎突综合症的临床特点、治疗及疗效。方法回顾分析1986年1月~2004年12月我院收治的25例茎突综合症病人的临床资料、治疗及疗效。结果本组病例中单侧发病者10例,双侧者15例;咽痛前来就诊者16例,单纯咽异物感者6例,耳痛、头痛及颈部痛者各1例。所有病人均行口内径路茎突截短术。术后随访6个月以上,其中症状消失者18例(72%),症状减轻者3例(12%),症状无改善者4例(16%)。结论完整的病史、临床检查及影像学检查有助于茎突综合症的诊断。口内径路行茎突截短术是治疗该病的有效方法。     

口内径路保留扁桃体的茎突截短术

目的探讨口内径路保留扁桃体茎突截短术的手术方法.方法总结10例口内径路保留扁桃体茎突截短术患者的临床特点、诊断和手术方法.结果10例患者均痊愈,术后反应轻,康复快,无并发症发生.结论口内径路保留扁桃体的茎突截短术是值得推广的手术方法.     

经颌下径路治疗茎突综合征

报告３０例（３５侧）茎突综合征经颌下径路茎突截短术。其中茎突舌骨韧带骨化２例，茎突骨折１例。术前被误诊为牙痛而我次拔牙１例，Ｘ线照片 诊１便。经颌下矩路术前茎突长３－７．５ｃｍ，平均右４．１３ｃｍ，左４．３８ｃｍ；手术截除猎庆右２．１３ｃｍ左２．２６ｃｍ；术后存留工庆右２．０ｃｍ，左２．１２ｃｍ。要后经２月至６年随访，显效６５．７％，好转２８．６％，无效５．７。经咽径路茎突截短３例，其中１例术后发     

改良颈外径路茎突截短术41例报告

茎突综合征由 Eaglel(1 93 7)最早报道。本病以手术治疗为主 ,目前多采用经咽或颈外径路 ,但均有其缺点和不足。近年亦有经颌下径路的报道〔1〕。我科自 1 992年始采用改良颈外径路茎突截短术治疗茎突综合征患者 41例 (6 9侧 ) ,取得满意疗效 ,现报告如下。1 　 资料与方法1 .1 　 临床资料茎突综合征患者 41例 ,其中男 1 7例 ,女 2 4例 ;年龄 2 1～ 6 0岁 ,平均 3 9岁。病程 1个月～ 7年 ,平均 1年零 1 0个月。术前 X线茎突片显影长度为2 .5～ 5 .5 cm,其中左侧平均 3 .5 7cm,右侧 3 .6 4cm。手术截短 0 .7～ 4.0 cm。术前症状 :咽异物感…     

以头颈部疼痛为首发症状的茎突综合征分析

目的　探讨茎突综合征患者的临床表现、手术方式及术后效果,增强耳鼻咽喉科医师对该疾病的认识。方法　回顾性分析我科2012年12月～2017年1月收治的24例以头颈部疼痛为首发症状的茎突综合征患者的手术方式,并使用视觉模拟评分法（visual analogue scale,VAS）评估患者术后效果。结果　首发症状表现为咽痛14例,颈部胀痛5例,耳痛4例,颌面部疼痛1例。茎突CT三维重建示24例患者患侧茎突长度均＞30 mm。全部患者扁桃体窝触痛阳性。18例患者经颈外入路茎突截短术,6例患者经口扁桃体切除后行茎突截短术。术后随访3～20个月,21例症状缓解,3例症状较前无改善,有效率87.5%。VAS评分术前与术后比较差异有统计学意义（t =10.112,P <0.05）。结论　以头颈部疼痛就诊的茎突综合征患者易被误诊为咽炎、外耳道炎、淋巴结炎等疾病,扁桃体窝触诊是重要的辅助手法,茎突CT三维重建具有确诊价值。诊断明确者可考虑行茎突截短术,术后效果较满意。     

茎突截短术后并发症的观察及护理

茎突位于颞骨岩部底面和乳突部相接处,为细长圆柱状,附有茎突舌骨肌和茎突舌骨韧带等.茎突形状、方位或长度的异常均可刺激和压迫周围的血管神经,引起咽痛、颈痛、咽异物感和颈动脉压迫症状等,称为茎突综合征(styloid syndrome).1993至2003年我们共为146例行茎突截短术,发生并发症11例,现将护理体会报告如下.     

94例茎突综合征临床特点及诊疗思考

目的 根据94例茎突综合征患者的临床症状、专科查体以及影像学检查判断其临床特点和术后疗效.方法 对2010年1月～2019年1月间94例茎突综合征病例回顾性分析,通过颈外进路茎突截短术、扁桃体切除术+茎突截短术、保留扁桃体茎突截短术三种手术方式,分析术后疗效.结果 94例患者茎突截去长度为25 ～61 mm,平均33 ...     

A complete stylohyoid bone with a stylohyoid joint

Different clinical entities are associated with elongation of the styloid process or ossification of the stylohyoid ligament. Although partial ossification of the stylohyoid ligament is not uncommon, complete ossification is rare. We present a rare case of complete ossification of the stylohyoid ligament. This case may represent the extreme end of the spectrum of entities known as cervicopharyngeal pain syndrome, which includes Eagle's syndrome, stylohyoid syndrome, and pseudostylohyoid syndrome.     

A case of bilaterally elongated styloid processes

Elongated styloid process gives a complex of symptoms described by Eagle such as unilateral craniofacial and cervical pain, recurrent throat pain, dysphagia and foreign body sensation. Symptoms might be similar to those caused by calcified stylohyoid ligament. Diagnosis of the elongated styloid process is based on the palpation of the tonsillar area and should be confirmed radiologically. Surgical shortening of the elongated process is the only way to give symptomatic relief to the patient. The authors present a surgically treated case of bilaterally elongated styloid processes and unilateral symptoms.     

Elongated styloid process as a cause of dysphagia

An elongated styloid process or a calcified stylohyoid ligament may cause dysphagia or craniofacial and cervical pain. Palpation and radiography confirm the diagnosis provided that it is considered. The only effective treatment is surgery. Eleven patients undergoing surgery for elongated styloids or calcified ligaments are reported. In all cases the symptoms disappeared or were relieved. An evaluation of the external versus the transoral approach is presented. The authors recommend the external one, as it provides adequate anatomical exposure of the styloid process and its relationship to the structures of the parapharyngeal space.     

Three-dimensional computed tomography and surgical treatment for Eagle's syndrome

Eagle's syndrome represents a group of symptoms that includes recurrent throat pain, globus pharyngeus, dysphagia, referred otalgia, and neck pain possibly caused by elongation of the styloid process or ossification of the stylohyoid or stylomandibular ligaments. The medical history and physical and radiologic examinations are the main guides to the precise diagnosis. The radiologic diagnostic modality of choice is three-dimensional computed tomography (3-D CT). We describe a case of bilaterally symptomatic Eagle's syndrome that was diagnosed by 3-D CT of the styloid processes and successfully treated with surgery via a transoral approach.     

Studies on the compression of the external carotid artery in the region of the styloid process of the temporal bone

The styloid process syndrome and the stylo-keratohyoid syndrome are well-known diseases caused by an elongated styloid process of the temporal bone or by ossification of the derivations of the second branchial arch. The cause of the complaint is a compression of neighbouring vessels, nerves and soft tissues. 85 anatomical specimens were investigated in respect of a compression of the external carotid artery by the stylohyoid muscle. In 7 cases we found an impression of the vessel caused solely by the stylohyoid muscle without ossification of the derivations of the second branchial arch or elongation of the styloid process. In some cases the posterior auricular artery was also compressed. In addition, the extent of the stenosis of the external carotid artery was examined quantitatively. At least a histological examination was performed. The symptoms of the diseases are discussed by a review of the literature. Difficulties in X-ray diagnosis or diagnosis by bimanual palpation are pointed out.     

Eagle's syndrome. Report of a case and literature review

Eagle's syndrome produces recurrent throat pain, foreign body sensation, dysphagia/odinophagia or facial pain due to an elongated styloid process or calcified stylohyoid ligament. We report the clinical case of a 56 years old female who had consulted several times to our by Emergency Service relating these symptoms and she was finally diagnosed as this uncommon pathology. Up to now the patient has been controled with analgesics but not surgical treatment. We have performed a short bibliographic review about this syndrome.     

Styloid syndrome and its treatment

BACKGROUND: An elongation of the styloid process or an ossification of the stylohyoid ligament can be the cause for a styloid syndrome and may lead to craniocervical pain, globus sensation and dysphagia. Pathophysiologically, the styloid syndrome is related to an irritation of the surrounding nerves, the carotid artery or the pharyngeal mucosa. There are various alternatives for its treatment. PATIENTS AND METHODS: This study analyzed retrospectively the data of eleven patients, who were treated for a styloid syndrome. All patients were placed on a stepwise therapy plan, which began with a medicamentous treatment, followed by a surgical treatment, if the problems persisted. The surgical approach included a transoral styloid fracture and/ or a surgical styloid shortening, which was carried out either transorally or transcervically. RESULTS: Three of the eleven patients presented no complaints after the medical treatment and did not require any further therapy. In two out of five patients, transoral fracturing of the styloid was successful. Six patients underwent surgical resection of the styloid process. In five cases a transoral route was used and in one cases a transcervical route. Postoperatively, four patients were free of symptoms and did not present any functional deficit. Two patients experienced severe complications with an ipsilateral medial cerebral artery infarction. These were related to a dissection of the internal carotid artery (ICA) in one case, and an arrosion bleeding of the ICA after the formation of an abscess of the parapharyngeal space in the other case. CONCLUSION: A stepwise therapy of the styloid syndrome including medicamentous treatment, transoral styloid fracture and resection of the styloid process has proven to be of value. If the styloid process can be palpated submucosally, a transoral resection may be chosen. However, using this route, the possibility of severe complications has to be taken into consideration, such as injury of the internal carotid artery.     

Eagle syndrome: classic and carotid artery types

OBJECTIVE: To present a number of cases with elongated styloid process (Eagle) syndrome and to discuss the clinical presentation of this disorder. METHODS: A clinical study of patients operated on at King Abdul-Aziz University Hospital, Riyadh, from 1992 to 1996. RESULTS: The study group consisted of seven patients (six females and one male ranging in age from 20 to 43 years). Symptomatically, two distinct groups of patients could be identified: the classic syndrome (including three patients), which occurs in the tonsillectomized patients, and the styloid-carotid artery syndrome (including four patients), which occurs independently of tonsillectomy. In the first type, patients usually complain of spastic and nagging pain in the pharynx radiating to the mastoid region. In the second group, patients usually complain of attacks of syncope in association with pharyngeal pain referred to the course of the carotid artery. Diagnosis is made by history taking, palpating the tonsillar fossa, and radiographic demonstration of the process. Three-dimensional computed tomography reconstruction images were found to be very reliable in measuring the actual length of the styloid process and the stylohyoid ligament. CONCLUSION: This unusual disorder should be considered in the differential diagnosis of facial pain in some patients and as the cause of syncope in other patients. The paper discusses the embryologic, anatomic, pathogenetic, clinical, and therapeutic aspects of elongated styloid process with calcified stylohyoid ligament and the differential diagnosis is detailed.     

Tonsillectomy sparing transoral robot assisted styloidectomy

Eagle Syndrome can present with a variety of symptoms and be caused by an elongated styloid process or calcified stylohyoid ligament. Patients failing medical management of this disorder may be treated with surgical excision of the styloid process. In the literature, transoral and transcervical approach have both been described. Although transoral approaches typically begin with a tonsillectomy, tonsil-sparing approaches have also been utilized. With the advent of robotic surgery, the potential for a tonsillectomy sparing approach has become a feasible alternative, preventing the pain and morbidity associated with adult tonsillectomy while continuing to provide superior exposure and instrumentation. We report three successful cases of patients treated with tonsillectomy sparing transoral robot assisted styloidectomy. This represents the first application of this technique in the literature and suggests the potential for a paradigm shift in the surgical management of this disease.