Eagle syndrome: rare cause of chronic neck pain – A case report and review of the literature

Abstract

Background: Eagle's syndrome (ES) is a rare clinical disorder characterised by the aberrant elongation and ossification of the styloid process (SP), a narrow bony protrusion at the base of the skull or the calcification/ossification of the stylohyoid ligament and which may result in cervicofacial pain and dysphagia. It is also referred to as stylalgia, styloid syndrome, stylohyoid syndrome, or stylohyoid complex syndrome.

Methods: We report the case of a 58-year-old man who presented with an insidious onset of chronic bilateral neck pain of three years duration, worse on the right side, with recent progression and associated dysphagia. There is no prior history of previous neck surgery or trauma. Craniofacial computed tomography (CT) done with axial, reformatted coronal and three-dimensional (3D) volume rendered images revealed elongation of the temporal bone styloid processes, with associated ossification of the stylohyoid ligaments bilaterally, extending inferiorly to abut the hyoid bone, and measuring about 6.60cm and 6.39cm in length for the right and left respectively (normal <3cm). There is no gross carotid arterial or jugular venous compression noted.

Results: A diagnosis of bilateral Eagle's syndrome was made. The patient declined surgical intervention and was managed conservatively with non-steroidal anti-inflammatory drugs, gabapentin, and amitriptyline. He was subsequently lost to follow-up.

Conclusion: To the best of our knowledge, this is one of the earliest reported radiologically diagnosed case of Eagle's syndrome in Warri, Delta State, Southern Nigeria.