Eagle syndrome with bilateral stylohyoid ossification: a surgical case report with anatomical correlation

Introduction and importance: Eagle syndrome is a rare clinical condition characterized by craniofacial pain and a wide range of associated symptoms. This syndrome is characterized by the elongation of the styloid process of the temporal bone and/or the calcification of the stylohyoid muscle tendon. The stylohyoid muscle elevates and retracts the hyoid bone during swallowing and contributes to mandibular depression through its anatomical interaction with the digastric muscle. In this case, clinical evaluation and anatomical knowledge led to the diagnostic suspicion and a minimally invasive and resolutive surgical approach. Case presentation: We report the case of a patient who had suffered for years from dental pain, odynophagia, temporal headache, neck pain, and dysphagia. Clinical and instrumental examinations were normal. CT imaging of the neck revealed elongation and ossification of the styloid processes, consistent with Eagle syndrome. A bilateral open transcervical surgical procedure was performed to remove the ossified segments. The surgery resulted in complete symptom resolution. Discussion: The correlation of symptoms, combined with in-depth knowledge of the functional anatomy of the stylohyoid muscle, enabled the identification of the cause of the symptoms through a thorough diagnostic evaluation. The procedure, aimed at interrupting the altered action of the stylohyoid muscle at its insertion on the lateral body of the hyoid bone, was sufficient, minimally invasive, and led to the complete resolution of the symptoms. Conclusion: The surgical technique adopted proved to be safe and effective, tailored to the patient’s clinical presentation and based on a detailed anatomofunctional correlation.