An intraoral surgical approach to the styloid process in Eagle's syndrome

Purpose: The purpose of this study is to present an alternative method to the extraoral surgical approach to remove the elongated styloid process, the intraoral surgical approach, and discuss their advantages and disadvantages. A literature review is also presented. Patients and methods: A casuistic of intraoral surgical approach to remove the elongated styloid process is presented in five patients. Results: Four patients experienced postoperative moderate pain and trismus for 1 week. Bilateral surgery in one patient caused severe trismus, great discomfort, and moderate difficulty in breathing. All were followed up for 6 months and showed complete relief of the oral pharyngeal symptoms and complete improvement in functional ability. Discussion: The advantages of the external approach are good visualization and reduced possibility of deep neck space infection. The disadvantages are an external scar, longer duration of surgery, and risk of injury to the facial nerve. The advantages of the intraoral approach are that the method is safe, simple, and less time consuming and an external scar is avoided. The disadvantages are possible infection of deep neck spaces, risk of injury to major vessels, and poor visualization. Conclusions: Intraoral resection of the styloid process is a safe treatment technique of Eagle's syndrome. It is not recommended the bilateral intervention at the same surgery, because of possible great discomfort at postoperative time. © Springer-Verlag 2009.