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El proceso estiloides es una delgada prominencia ósea cónica localizada en la superficie inferior del hueso temporal. Su longitud normal es de 20 a 25 mm, siendo mayor en los hombres. En ocasiones se produce su elongación o deformación con calcificación del ligamento estilohioideo, acompañado de diversos signos y síntomas lo que da origen al llamado síndrome de Eagle. La presencia de dolor inespecífico oro-cérvico-facial y la palpación de los procesos estiloides en la fosa tonsilar proporcionan un diagnóstico presuntivo que deberá ser confirmado con estudios por imágenes como la telerradiografía lateral de cráneo y la ortopantomografía. Se presenta un caso de síndrome de Eagle en un paciente de sexo masculino referido al Servicio de Diagnóstico por Imágenes de la Facultad de Odontología de la Universidad Nacional de Córdoba. La tomografía computada constituye el estudio por imágenes de excelencia ante la presunción de este síndrome ya que los diferentes cortes tomográficos y la reconstrucción 3D nos permiten observar los procesos estiloides elongados de manera precisa e inequívoca. Este diagnóstico es de gran relevancia ya que dependiendo de la severidad de la sintomatología el tratamiento puede ser quirúrgico para evitar las graves y s everas complicaciones que a veces suele ocasionar.

Styloid process is defined as a thin conical bony prominence located on the undersurface of the temporal bone. Its normal length is 20 to 25 mm. Sometimes styloid process is elongated with ossification of stylohyoid ligament and when it is accompanied by a set of signs and symptoms it gives rise to the so called Eagle´s syndrome. Nonspecific pain in the oral cervicofacial area and styloid process palpation in the tonsillar fossa provide a presumptive diagnosis that should be confirmed by imaging studies such as lateral skull teleradiography and orthopantomography that confirm the elongation of styloid processes. An Eagle syndrome case of a male patient referred to the Department of Radiology at the National University of Córdoba School of Dentistry is reported. The computed tomography is the most accurate imaging modality for Eagle´s syndrome identification because through multiplanar reformatted images and three dimensional images allows to observe the elongated styloid processes in a precise and unequivocal way. This diagnosis is relevant since depending on the severity of the symptoms, surgical treatment may avoid serious and severe complications.

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Eagle syndrome is a rare condition presenting with retroauricular pain (usually as main symptom) associated with dysphagia, headache, neck pain on rotation and, much rarelier, stroke. This occurs due to styloid process elongation. Sometimes, there is also styloid ligament calcification, which can cause compression of nerves and arteries and the symptoms above. Treatment can be conservative with pain modulators (e.g. pregabalin) or infiltrations (steroids or anesthetics drugs). In refractory cases, surgical approach aiming to reduce the size of the styloid process can be performed. We present a rare case of Eagle syndrome (documented by computed tomography) with good response to clinical treatment.

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Summary Eagle syndrome is a rare condition presenting with retroauricular pain (usually as main symptom) associated with dysphagia, headache, neck pain on rotation and, much rarelier, stroke. This occurs due to styloid process elongation. Sometimes, there is also styloid ligament calcification, which can cause compression of nerves and arteries and the symptoms above. Treatment can be conservative with pain modulators (e.g. pregabalin) or infiltrations (steroids or anesthetics drugs). In refractory cases, surgical approach aiming to reduce the size of the styloid process can be performed. We present a rare case of Eagle syndrome (documented by computed tomography) with good response to clinical treatment.

Resumo A síndrome de Eagle é uma condição rara na qual ocorre dor retroauricular (usualmente é o principal sintoma) associada a disfagia, cefaleia, cervicalgia durante a rotação da cabeça e, mais raramente, a AVC. Isso ocorre por conta do alongamento do processo estiloide e, às vezes, há também calcificação do ligamento estiloide. Essas estruturas podem comprimir nervos e artérias causando os sintomas citados. O tratamento pode ser conservador com moduladores da dor, como pregabalina, ou com infiltrações (corticoides ou drogas anestésicas). Em casos refratários, cirurgia para reduzir o tamanho do processo estiloide pode ser realizada. É apresentado um caso raro de síndrome de Eagle (documentado com tomografia computadorizada) com boa resposta ao tratamento clínico.

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OBJECTIVE: This article aimed to summarize our clinical experience with a standardized tonsil-sparing transoral surgical approach used for treatment of styloid process-carotid artery Eagle's syndrome. METHODS: Eleven consecutive patients, from 2007 to 2013, underwent surgical treatment to remove elongated styloid apophyses transorally. Outcomes were assessed in terms of intraoperative and postoperative complications and patients' evolution. RESULTS: No patient experienced any intraoperative or postoperative complications. All patients have been followed up to present and 10 of them have shown complete relief of the symptoms and improvement of functional ability. CONCLUSION: The tonsil-sparing transoral surgical approach described is suitable for treating patients with elongated styloid apophyses.

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Spondyloarthritis is a group of several related but phenotypically distinct chronic inflammatory diseases, characterized by progressive new bone formation which leads to ankylosis and functional disability. Radiographic images evidence not only erosive changes but also overgrowth of bony structures called syndesmophytes. These inflammation, bone destruction and new bone formation are located in the entheses, which constitutes the primary organ of the disease. As a consequence, the inflammatory process results in excess of bone formation and the impact depends on the location, cell type, cytokines and local microenvironment factors. Several molecules playing a role as immune modulators or regulators of bone homeostasis, mediate the imbalance between bone resorption and formation. In the same way, animal models suggest that joint ankylosis may be independent from the effects of tumor necrosis factor alpha. Therefore, the process of new tissue (bone) formation can be considered as an additional therapeutic target. The Wnt signaling pathway, which is considered the primary regulator of osteoblastogenesis, constitutes a new research field of great interest in the last decade.

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Spondyloarthritis is a group of several related but phenotypically distinct chronic inflammatory diseases, characterized by progressive new bone formation which leads to ankylosis and functional disability. Radiographic images evidence not only erosive changes but also overgrowth of bony structures called syndesmophytes. These inflammation, bone destruction and new bone formation are located in the entheses, which constitutes the primary organ of the disease. As a consequence, the inflammatory process results in excess of bone formation and the impact depends on the location, cell type, cytokines and local microenvironment factors. Several molecules playing a role as immune modulators or regulators of bone homeostasis, mediate the imbalance between bone resorption and formation. In the same way, animal models suggest that joint ankylosis may be independent from the effects of tumor necrosis factor alpha. Therefore, the process of new tissue (bone) formation can be considered as an additional therapeutic target. The Wnt signaling pathway, which is considered the primary regulator of osteoblastogenesis, constitutes a new research field of great interest in the last decade.

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Eagle syndrome is characterized by recurrent clinical symptoms like globus, dysphagia and odynophagia, which can be explain by an abnormal elongation of the Estiloid Apophysis or the calcification of the estilohioid ligament. It affects in equal proportion to men and women, being most common in people older than 50 years. Its importance is that it appears as a differential diagnosis compared with other causes of cervicofacial pain, being its election treatment, the surgical resection of the Estiloid apophysis. The following is a review of the literature and a clinical case of a 44 years old man, who consulted with a history of 6 months of odynophagia, foreign body sensation and cervicalgia. After the clinical, endoscopic and the complementary study of images evaluation, it was concluded that this was an Eagle Syndrome.

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