Eagle's syndrome secondary surgical treatment. Report of a case

Eagle's Syndrome is reported to be the symptomatic calcification of the stylohyoid complex. Calcification of the stylohyoid ligament is a relatively common finding in the general population, however only a small percentage of these people presents symptoms. According to the kind of symptoms described by the patients it is possible to recognise two syndromes: the classic one, which occurs after a tonsillectomy, and stylo-carotid artery syndrome, which is independent from a tonsillectomy. The only effective treatment in symptomatic cases is the surgical shortening of the styloid process. The case presented underlines the problems due to the persistence of the calcified caudal portion of the stylohyoid ligament after a first surgical removal. A second surgical treatment is suggested for a complete resection of the calcified ligament which was causing the symptomatology complained by the patient. This patient had previously undergone surgical shortening of the stylohyoid ligament after he was diagnosed as having Eagle's Syndrome, of the styloid-carotid artery type. After a stylohyoidectomy, he still suffered from dysphagia, neck pain and scratching sensation when swallowing. Further surgical treatment was necessary, with the aim of removing the caudal portion of the ligament, which was causing the patient's symptoms. An extra-oral approach was used and, after surgery, the patient was completely relieved of the symptoms. Conventional and three-dimensional CT were performed after surgery, they showed the complete absence of the left calcified stylohyoid ligament.