Intra Oral Versus External Approach in the Surgical Management of Eagle’s Syndrome
International Journal of Otorhinolaryngology
Volume 5, Issue 1, June 2019, Pages: 9-14
Received: Jan. 16, 2019;
Accepted: Mar. 2, 2019;
Published: Mar. 21, 2019
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Balde Djibril, ENT-CFS Department, Regional Hospital Heinrich Lubke, Diourbel, Sénégal
Do Santos Zounon Alexis, ENT-CFS Department, Faculty of Health Sciences, University of Abomey Calavi, Cotonou, Bénin
Ndiaye Ciré, ENT-CFS Department, University Hospital Center of Fann, Dakar, Sénégal
Dione Abdoulaye, Radiology Department, University Hospital Center of Fann, Dakar, Sénégal
Diallo Baye Karim, ENT Department, Albert Royer Hospital Center Fann, Dakar, Sénégal
Adjibabi Wassi, ENT-CFS Department, Faculty of Health Sciences, University of Abomey Calavi, Cotonou, Bénin
Yehouessi-Vignikin Bernadette, ENT-CFS Department, Faculty of Health Sciences, University of Abomey Calavi, Cotonou, Bénin
Eagle syndrome is defined as an elongation of the styloid process. It is a radioclinic entity characterized by heterogeneous polymorphic symptomatology. Its management is essentially through intra oral or external surgery. The objective of our work is to highlight the various diagnostic means and to propose a surgical therapeutic attitude on the clinical and radiological basis. This is a retrospective study performed at the ENT department of the Heinrich Lübké Hospital in Diourbel between March 2015 and March 2017. The study involved 15 patients with confirmed Eagle's syndrome based clinical and computed tomography evidence. Epidemiological, diagnostic and therapeutic data were collected from patient records and the Operative Record register. The choice of the surgical approach was based on Langlais’ classification, the measurement of the styloid process and the complications. The study included 15 patients, counting 14 women and one man with a sex ratio (male / female) of 0.071. The age of the patients varied between 23 years and 55 years with an average of 31.33 years. The chief complaints were foreign body sensation in the throat (15 patients, 100%), headache (15 patients, 100%), dysphagia (11 patients, 66.6%), neck pain (6 patients; 40%), periorbital and temporal pain (5 patients, 33.33%), otalgia with tinnitus (4 patients, 26.66%). The average size of the styloid process was 4.085 cm (1.608 inches). Only one patient received exclusively medical treatment. The others received surgical treatment by external approach (9 patients, 64.3%) or intra-oral approach after prior tonsillectomy (5 patients, 35.7%). The styloidectomy was bilateral in 10 patients (71.14%) and unilateral in 4 patients (28.57%). Eagle syndrome is a condition considered rare. Its curative treatment is essentially surgical with an intraoral or external approach. We recommend the external approach because it offers a better exposure of the operative field, and control of the cervical neurovascular elements. The external approach generates little postoperative pain thereby shortening the period of hospitalization.
Do Santos Zounon Alexis,
Diallo Baye Karim,
Intra Oral Versus External Approach in the Surgical Management of Eagle’s Syndrome, International Journal of Otorhinolaryngology.
Vol. 5, No. 1,
2019, pp. 9-14.
Anh D, Stellios K, John S. L, Roy M. F, Farhood S: Eagle syndrome presenting with external carotid artery pseudoaneurysm. Emergency Radiology. 2011; 18, 3:263-265.
Farhat HI, Elhammady MS, Ziayee H, Aziz-Sultan MA, Heros RC: Eagle syndrome as a cause of transient ischemic attacks. J Neurosurg. 2009; 110, 1: 90-93.
Ben Gamra O, Rhomdane N, Euch W, Abdid W, Belhadj F, Hariga I, Mbareck Ch: Le Syndrome d’Eagle. J. TUN ORL-N035 JUIN 2016: 54-55.
P. Pigache, C. Fontaine, J. Ferri, G. Raoul. Transcervical styloidectomy in Eagle’s syndrome. European Annals of Otorhinolaryngology, Head and Neck diseases 2018; 135(6):433-436.
Shilpa H, Mathew AS, Hemraj S, Sridhar A. Endoscopic transoral resection of an elongated styloid process: a case report. Int J Otorhinolaryngol Head Neck Surg 2018;4:1317-20.
Filippo Montevecchi, Alberto Caranti, Giovanni Cammaroto, Giuseppe Meccariello, Claudio Vicini. Transoral Robotic Surgery (TORS) for Bilateral Eagle Syndrome. ORL 2019; 81(1):36–40. DOI:10.1159/000493736.
Müderris T, Bercin S, Sevil E, Beton S, Kiris M. Surgical management of elon-gated styloid process: intraoral or transcervical? Eur Arch Otorhinolaryngol 2014; 271 (6):1709–13.
Fusco DJ, Asteraki S, Spetzier RF. Eagle’s syndrome: embryology, anatomy, andclinical management. Acta Neurochir 2012;154 (7): 1119–26.
Ankit A. S, Nirali V. C, Ajay G, Kayedjihar R: Lidocine Infiltration Test: An useful test in the prediction of results of styloïdectomy for Eagles’s syndrome. Indian Journal of otolaryngology and Head & Neck Surgery. 2013; 65, 1:20-23.
Faiçal Choumi, Yassine Ziani: Syndrome d’Eagle à propos d’un cas. PanAfrican Medical Journal. 2014; 18:333.
Chandramani B M, Mukesh K A: Eagle’s Syndrome: Report of three cases. Indian Journal of otolaryngology and Head & Neck Surgery. 2011; 63, 4: 396-399.
Fumihiko M, Kaori K, Misato K, Hiroaki K, Takako O, Katsuhisa I: Endoscopy-assisted transoral resection of the styloid process in Eagle’s syndrome. Head & Face Medecine. 2012, 8: 21.
Hossein R, Kambiz M, Mohammad D, Mina N: Complete recovery after an intraoral approach for Eagle syndrpme. J Craniofac Surg. 2010; 21, 1: 275-276.
Lonka MM, Schouseboe LP: Unilateral atypical neck pain in Eagle syndrome. Ugeskr Laeger. 2012; 174, 18: 1242-1243.
Sanjeev M, Thirumaran N. S, Gopinath M, Gaurav B, Shalini B: Significance of styloïdectomy in Eagles’s syndrome: an analysis. Indian Journal of otolaryngology and Head & Neck Surgery. 2009; 61, 4:262-265.
Strauss M, Zohar Y, Laurian N: Elongated styloid process syndrome: intraoral versus external approch for styloid surgery. Laryngoscope. 1985; 95, 8:976-979.
Vijay Chourdia: Elongated styloid process (Eagle’ssyndrome) & Severe headache. Indian Journal of otolaryngology and Head & Neck Surgery. 2002; 54, 3:238-241.
Vinod K, Govind J, Sandeep G: Eagle’s syndrome: A New surgical technique for styloïdectomy. Journal of Maxillofacial and Oral Surgery. 2015; 14, 1: 360-365
Haluk Y, Fatma C, Tulin Y, Levent N. O: Angulation of the styloid processus in Eagle’s syndrome. European Archives of Oto-Rhino-Laryngology. 2008; 265: 1393.
Piagkou M, Anagnostopoulou S, Kouladouros K, Piagkos G: Eagles’s syndrome: A review of the literature. Clin Anat. 2009; 22; 5: 545-558.
Eike H, Christian R, Hendrik F: Styloid-carotid atery syndrome treated srgically with piezosurgery: A case report and literature review. 2013; 43, 2: 162-163.
Yoshifumi N, Kazui Y: Perioperative management of Eagle syndrome complicated by carotid artery dissection. Journal of Anesthesia. 2014; 28, 2:291-293.
Min Kyu Han, MD, DO Wan Kim, MD, et Jong Jeun Yang, MD: Non Surgical Treatment of Eagle’s Syndrome- A case Report. Korean J Pain 2013 April; 26, 2: 169-172.
Balde D, Ayi Megnanglo A, Diallo B. K: Le syndrome d’Eagle: à propos d’un cas. Rev Laryngol. Otol Rhinol. 2015; 136, 3: 121-123.