Three-Dimensional Identification of Vascular Compression in Eagle’s Syndrome Using Computed Tomography: Case Report

Abstract

Eaglés syndrome, characterized as a painful debilitating condition that involves the cervicofacial region, is based on ossification of the stylohyoid ligament, which constitutes part of the stylohyoid complex, [1], [2] and [3] resulting in elongation of the temporal bone styloid process. [4] and [5] It was Eagle in 19376 who first described the syndrome, associating it with previous tonsillectomy. Later, when making deeper inquiries into this condition, he noticed that individuals without a previous history of surgery in the oropharyngeal region also presented with a similar profile of symptoms. [7] and [8] In such cases, pain was closely related to stimulation of the carotid vasculature by ossification of the stylohyoid ligament; this clinical presentation was known as carotid artery syndrome. [1], [2], [3] and [4] Several reports in the literature have correlated the length of the elongated styloid with the severity of symptoms in this painful syndrome. [3], [5], [9], [10] and [11] However, no confirmation of vascular compression caused by this pathology is observed in the cases described. In the present report, a case of Eagle’s syndrome is described and the use of volumetric reconstruction, obtained by computed tomography (CT) images to study the vascular compression by the ossified ligament, is discussed. It was observed on the image examination of the patient that the jugular vein was the vascular structure that underwent the most important compression, and that the elongation of the styloid process was not the only factor in compression of the carotid arteries.