Styloid Process; Correlation Between Symptoms, Palpability and Measurements on Three Dimensional Computed Tomography

Styloid process is a long and slender osseous projection protruding downward, forward and slightly medially from the temporal bone and serves as an anchor point for various muscles associated with the tongue and the larynx. The aim of the present study was to record the length and the angle of Styloid process on three dimensional computed tomography in patients with unilateral symptomatic and palpable styloid process and compare the length and the angle of styloid process of symptomatic side to asymptomatic side on three dimensional computed tomography. 3D-CT face reconstruction were perfomed in all 35 patients (17 females, 18 males of age range 25-69 years). The length of the styloid process and its angulation (transverse and sagittal angles) were measured by means of three dimensional and multiplanar reconstruction images. The length of styloid process on symptomatic side had a mean of 33.61 +/- 5.08 mm while on asymptomatic side mean was 31.11 +/- 5.02 mm. The mean transverse angle on symptomatic sides had a mean of 72.37 degrees +/- 4.48 degrees while on asymptomatic side mean was 74.17 degrees +/- 4.48 degrees. The mean sagittal angle seen on symptomatic side was 88.11 degrees +/- 5.21 degrees while on asymptomatic side was 87.88 degrees +/- 5.03 degrees. Symptomatic side has a longer styloid. Length of the styloid process has a statistical correlation with the symptoms and symptomatic side has a longer styloid. Though there was a difference in transverse and sagittal angulation in symptomatic versus asymptomatic side; but it was not statistically significant. On examination of the opposite asymptomatic side, 5 patients had a palpable styloid process therefore we infer that long styloid process may not always be associated with symptoms. Patients with cervicofacial pain should be evaluated for Eagle syndrome by palpation of styloid process in the tonsillar fossa and further by three dimensional computed tomography (3D-CT). 3D CT is an effective tool in evaluating patients with cervicofacial pain and making a diagnosis of Eagle's syndrome. Therefore, 3D CT should be performed while evaluating patients with these symptoms.