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      An evaluation of the prevalence of elongated styloid process in Taiwanese population using digital panoramic radiographs

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          Abstract

          Background/purpose

          Styloid process (SP) was an anatomical structure located in front of the stylomastoid foramen and the occurrence of styloid process elongation was uncertainly reported. The purpose of this study was to survey, using digital panoramic radiography, the lengths of styloid process (SP) and the prevalence of elongated SP in the Taiwanese population. Their relationships with age, gender and laterality were also determined.

          Materials and methods

          A total of 539 patients (including 53 that were referred from the Department of Otorhinolarygngology with clinical symptoms) were studies retrospectively. Panoramic radiographic examinations were performed on all these patients at the Outpatient clinics of the Department of Stomatology, Taichung Veterans General Hospital between January 2019 and December 2019. Patients were divided into groups according to their age and gender. The length of SP from the base of temporal bone junction to the tip of the process was measured using the Sirona software. Data were analyzed using SPSS version 22.0 based on tests of Chi-square, Mann–Whitney U and Kruskal Wallis tests. Statistical significance was set at p < 0.05.

          Results

          A total of 539 (240 males and 299 females) digital panoramic radiographs were measured and evaluated in this study. The mean length of SP was 30 ± 0.7 mm on the right side and 29 ± 0.7 mm on the left side. The average length of SP on both sides was 29.5 ± 0.7 mm. In those cases with symptomatic Eagle syndrome, the mean length of SP was 32 ± 0.8 mm on the right side and 33 ± 0.8 mm on the left side (average 32.5 ± 0.8 mm). These lengths were statistically different between the general population and the symptomatic patients. Furthermore, the mean length of SP was 29 ± 0.7 mm in females and 30 ± 0.7 mm in males. The length of the SP grew progressively with age, and was more clearly seen within subjects from 41 to >60 years of age (p < 0.005). Meanwhile, the prevalence of elongated SP in our study was 41.5% on the right side and 36.2% on the left side, with female predominance.

          Conclusion

          The mean length of SP was 30 ± 0.7 mm (right side) and 29 ± 0.7 mm (left side). The prevalence of elongated SP was 41.5% on the right side, and 36.2% on the left side. Our findings were consistent with some previous studies that were differences related with age, and were more prominent in those patients with symptoms.

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          Most cited references39

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          Symptomatic elongated styloid process; report of two cases of styloid process-carotid artery syndrome with operation.

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            Incidence of the type and calcification patterns in patients with elongated styloid process.

            We investigated the incidence of elongated styloid process (Eagle's syndrome) using panoramic radiographs taken of 860 patients referred to our clinic. Any styloid process identified was classified according to its length, type and the pattern of calcification. Fifty-nine elongated styloid processes were identified in 32 patients (3.7%), most being bilateral; 24 patients were female and eight were male (female/male ratio: 3:1). The mean age of these patients was 43 +/- 14 years (range: 18 - 78 years). Type I (elongated) was the most frequent type on both sides (42/59); and the most frequent patterns of calcification were partially calcified on the left side (18/59) and completely calcified on the right side (16/59). Only two patients were symptomatic. A corrected differential diagnosis is important to distinguish elongated styloid process from other pathologies with partially overlapping symptoms. We would recommend that clinicians consider the possibility of Eagle's syndrome when both the clinical and radiographic evidence support this diagnosis.
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              Styloid process variation. Radiologic and clinical study.

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                Author and article information

                Contributors
                Journal
                J Dent Sci
                J Dent Sci
                Journal of Dental Sciences
                Association for Dental Sciences of the Republic of China
                1991-7902
                2213-8862
                30 October 2021
                April 2022
                30 October 2021
                : 17
                : 2
                : 744-749
                Affiliations
                [a ]Division of Endodontics and Periodontics, Department of Stomatology, Taichung Veterans General Hospital, Taichung, Taiwan
                [b ]School of Dentistry, National Yang-Ming University, Taipei, Taiwan
                [c ]College of Oral Medicine, Chun Shan Medical University, Taichung, Taiwan
                [d ]Department of Radiology, Taichung Veterans General Hospital, Taichung, Taiwan
                Author notes
                []Corresponding author. Division of Endodontics and Periodontics, Department of Stomatology, Taichung Veterans General Hospital, 1650, Taiwan Boulevard Section 4, Taichung city, 40705, Taiwan. Fax: +886 4 23741329 kam@ 123456vghtc.gov.tw
                Article
                S1991-7902(21)00243-9
                10.1016/j.jds.2021.09.033
                9201539
                35756808
                6d1f2689-e082-4538-9f79-f00fd1e2db00
                © 2021 Association for Dental Sciences of the Republic of China. Publishing services by Elsevier B.V.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 19 August 2021
                : 15 September 2021
                Categories
                Original Article

                styloid process,eagle syndrome,elongated styloid process,panoramic radiography

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