Is there a Relationship Between Eagle Syndrome and Cervicofacial Painful Soft Tissue Rheumatisms? – Source: The Laryngoscope, Jul 31, 2008

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[Note: Eagle Syndrome can be the source of a wide variety of pains in the head and neck arising from nerve compression caused by a longer-than-normal styloid process. The styloid processes are spike-like bones that extend down and forward from the skull like stalactites below each middle ear, anchoring a number of tongue and larynx ligaments.]

Objectives/Hypothesis: To investigate the incidence of locomotor system pathologies such as myofacial pain syndrome (MPS), fibromyalgia syndrome (FMS), and temporomandibular dysfunction in patients with Eagle Syndrome.

Study Design: Prospective study.

Patients and Methods: Fourteen patients with Eagle Syndrome, who were treated surgically, were enrolled in the study. Etiologic factors for cervicofacial pain were assessed, pain status was compared preoperatively and postoperatively using visual analogue scale. Palpation of tonsillar fossa, neck and shoulder examination, neurologic examination, evaluation of occlusion status, trigger points, and painful zones were done. Plain anteroposterior and lateral radiographs of the cervical spine were obtained and the lengths of the transverse processes of the seventh cervical vertebrae were measured bilaterally.

Results: MPS, FMS, and temporomandibular dysfunction were diagnosed in 9 (64.3%), 3 (21.4%), and 2 (14.3%) patients, respectively.

Visual analogue scale scores decreased significantly after the surgical excision of elongated styloid processes (from 6.7 +/- 2.3 to 2.1 +/- 1.8), and all the complaints except for headache had diminished (P < .05).

Lengths of transverse processes of seventh cervical vertebra http://en.wikipedia.org/wiki/Vertebra_prominens [side projections where muscles & ligaments are attached to the spine] were found to be correlated with the length of styloid process (right; r = 0.644, P = .024, left; r = 0.616, P = .033).

Conclusions: Cervicofacial pain is a common complaint in patients with Eagle Syndrome. It frequently coexists with rheumatic disorders resulting in chronic pain such as MPS and FMS.

Even though Eagle Syndrome is a rare condition, it should be kept in mind in patients suffering from chronic cervicofacial pain that is refractory to treatment. Clinicians should be alert to diagnose and treat coexisting locomotor system disorders.

Source: The Laryngoscope, Jul 31, 2008. [Epub ahead of print] PMID: 18677284, by Zinnuroglu M, Ural A, Günendi Z, Meray J, Köybasoglu A. Departments of Physical Medicine & Rehabilitation and Ear, Nose & Throat Diseases, Gazi University School of Medicine, Ankara, Turkey [E-mail: muratz@gazi.edu.tr]

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