Styloid Process Syndrome

Abstract

Stiloidni je sindrom stanje kada produženi stiloidni nastavak ili kalcificirani stilohioidni ligament uzrokuje povremene boli i vratu, osjećaj stranog tijela ili neki drugi oblik retromandibularno-cervikalne boli. U odraslih stiloidni nastavak dug je oko 25 mm s vrškom koji se nalazi između vanjske i unutarnje karotidne arterije postranično od zida adrijela i tonzilarne udubine. Osifikacijom stilohioidnog i stilomandibularnoga ligamenta produžuju se stiloidni nastavak i klinički simptomi. U kliničkoj slici tri su sindroma tijesno povezana sa sindromom stiloidnog nastavka: Costenov, Trotterov i miofascijalni bolni sindrom. Dijagnozu je moguće postaviti kliničkim pregledom i palpacijom tonzilarne udubine, pri čemu se javlja bol. Rendgenski nalaz može pokazati nekoliko mogućih inačica: produženi, pseudoartikularni i segmentirani stiloidni nastavak, a po načinu kalcifikacije: perifernu, djelomičnu i potpunu kalcifikaciju, te nodularni oblik kalcifikacije. Liječenje je primarno kirurško. Važno je liječnikovo znanje o mogućim kliničkim inačicama i raznolikoj simptomatologiji. Autori prikazuju primjer bolesnice s kliničkom slikom stilohidnoga sindroma liječene kirurškim zahvatom skraćivanja produženoga stiloidnog nastavka.Styloid syndrome is a condition in which an elongated styloid process or calcified stylohyoid ligament causes occasional pain in the neck, a feeling of a foreign body (in the pharynx?) or some other form of retromandibular-cervical pain. In adults the styloid process is approximately 25 mm long with a tip which is located between the external and internal carotid arteries, lateral to the pharyngeal wall and the tonsillar fossa. Ossification of the stylohyoid and stylomandibular ligament causes prolongation of the styloid process and clinical symptoms. There are three syndromes closely connected with the styloid process syndrome: Costen\u27s, Trotter\u27s and Myofacial painful syndrome. Diagnosis can be made by a clinical examination and palpation of the tonsillar fossa, during which pain is felt by the patient. Radiographic finding may show several possible variations: elongated, pseudoarticulated and segmented styloid process, and according to the calcification: peripheral, partial, complete or nodular type calcification. Treatment is primarily surgical. The physician\u27s knowledge of possible clinical variations and diverse symptomatology is important. The authors present the case of a female patient with Stylohyoid Syndrome treated by surgical shortening of the elongated styloid process